Impact of Combined Acute Rejection on BK Virus-Associated Nephropathy in Kidney Transplantation.
10.3346/jkms.2013.28.12.1711
- Author:
Yoon Jung KIM
1
;
Jong Cheol JEONG
;
Tai Yeon KOO
;
Hyuk Yong KWON
;
Miyeun HAN
;
Hee Jung JEON
;
Curie AHN
;
Jaeseok YANG
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Acute Rejection;
BK Virus;
Kidney Diseases;
Kidney Transplantation
- MeSH:
Acute Disease;
Adult;
Antiviral Agents/therapeutic use;
BK Virus/*physiology;
Creatinine/blood;
Female;
*Graft Rejection/diagnosis/virology;
Humans;
Immunosuppressive Agents/administration & dosage;
Kidney/*virology;
Kidney Diseases/pathology/surgery/*virology;
*Kidney Transplantation;
Male;
Middle Aged;
Polyomavirus Infections/drug therapy/*etiology/pathology;
Retrospective Studies;
Tacrolimus/administration & dosage;
Time Factors;
Transplantation, Homologous/adverse effects;
Tumor Virus Infections/drug therapy/*etiology/pathology
- From:Journal of Korean Medical Science
2013;28(12):1711-1715
- CountryRepublic of Korea
- Language:English
-
Abstract:
BK virus-associated nephropathy (BKVAN) is one of the major causes of allograft dysfunction in kidney transplant (KT) patients. We compared BKVAN combined with acute rejection (BKVAN/AR) with BKVAN alone in KT patients. We retrospectively analyzed biopsy-proven BKVAN in KT patients from 2000 to 2011 at Seoul National University Hospital. Among 414 biopsies from 951 patients, biopsy-proven BKVAN was found in 14 patients. Nine patients had BKVAN alone, while 5 patients had both BKVAN and acute cellular rejection. BKVAN in the BKVAN alone group was detected later than in BKVAN/AR group (21.77 vs 6.39 months after transplantation, P=0.03). Serum creatinine at diagnosis was similar (2.09 vs 2.00 mg/dL). Histological grade was more advanced in the BKVAN/AR group (P=0.034). Serum load of BKV, dose of immunosuppressants, and tacrolimus level showed a higher tendency in the BKVAN alone group; however it was not statistically significant. After anti-rejection therapy, immunosuppression was reduced in the BKVAN/AR group. Renal functional deterioration over 1 yr after BKVAN diagnosis was similar between the two groups (P=0.665). These findings suggest that the prognosis of BKVAN/AR after anti-rejection therapy followed by anti-BKV therapy might be similar to that of BKVAN alone after anti-BKV therapy.
