Publication: BK Virus Associated Nephropathy, a Cause of Early Renal Allograft Dysfunction: A Single Centre Study
Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
BK virus associated nephropathy (BKVN) is an important cause of early graft
dysfunction in renal transplant recipients. The present study was carried out to
determine the burden of BKVN in a single renal transplant centre in Australia.
Method
A retrospective analysis of de novo renal transplant recipients from 2010 to 2013
was performed to identify biopsy proven BKVN. Estimated glomerular filtration rate
(eGFR) was compared at baseline, at BKVN diagnosis and 3 and 12 months post-
diagnosis.
Result
Of the 317 de novo renal transplants recipients in the study period, 20 (6.3%)
developed BKVN. The mean age was 54.8 ± 13.1 years and 13 (65%) were male. The
mean time from transplant to BKVN was 8.7 ± 6.7 months with 17 (85%) diagnosed
within 12 months. Four recipients each were diagnosed BKVN on 3 and 12 month
surveillance biopsy. Six (30%) had normal eGFR at diagnosis. Mean eGFR at diagnosis
was 38.8 ± 19.2 ml/min/1.73 m2, which was significantly lower (p < 0.01) than that
at baseline (50.3 ± 16.4 ml/min/1.73 m2). eGFR improved numerically at 3 and 12
months post-diagnosis, however the difference was not significant. One patient had
graft failure, 19 months after diagnosis.
Conclusion
BKVN generally occurs in first post-transplant year and is an important cause of early
graft dysfunction. Surveillance biopsy helps in detecting subclinical BKVN.
KEY WORDS
Immunosuppression, renal transplant, surveillance biopsy.
Description
Shrestha S,1 Kerr PG,2 Kanellis J,2 Polkinghorne KR,2 Brown F,2 Yii M,3 Mulley W2
1Department of Internal Medicine,
Nobel Medical College and Teaching Hospital,
Biratnagar, Nepal.
2Department of Nephrology,
Monash Medical Centre, and Department of
Medicine, Monash University,Melbourne, Australia.
3Department of Vascular Surgery,
Monash Medical Centre, Melbourne, Australia
Keywords
Immunosuppression, Renal transplant, Surveillance biopsy