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BK polyoma virus nephropathy in the native kidney

Shree G Sharma1, Volker Nickeleit, Leal C Herlitz

  • 1Department of Pathology, ColumbiaUniversity Medical Center, New York, NY, USA. drshreegopal@gmail.com

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|December 20, 2012
PubMed
Abstract

Insights

Polyoma virus nephropathy (PVN) in native kidneys is under-recognized in immunocompromised patients. Early diagnosis and treatment are crucial for better outcomes in BK polyoma virus infections.

Area of Science:

  • Nephrology
  • Virology
  • Immunology

Background:

  • BK polyoma virus nephropathy (PVN) is a known cause of kidney transplant dysfunction.
  • PVN in native kidneys is often under-recognized, despite its potential for severe renal damage.

Purpose of the Study:

  • To describe the pathological features, risk factors, and outcomes of PVN in native kidneys.
  • To highlight the importance of early diagnosis in immunocompromised individuals.

Main Methods:

  • Retrospective analysis of eight native kidney PVN cases.
  • Review of patient demographics, clinical presentation, immunosuppression status, pathology, viral markers, and treatment.
  • Assessment of outcomes including renal function and survival.

Main Results:

  • Eight immunocompromised males (age 16-73) with hematologic malignancies, transplants, or other conditions presented with acute kidney injury.
  • Pathology confirmed BK PVN with positive SV40 T antigen staining; some cases had JCV co-infection or CLL infiltration.
  • Despite treatment, six patients experienced worsening renal function, and three died, indicating poor outcomes linked to advanced disease and persistent immunosuppression.

Conclusions:

  • A high index of suspicion for PVN is essential in immunocompromised patients presenting with acute kidney injury.
  • Early diagnosis and prompt antiviral therapy may improve outcomes for native kidney PVN.
  • Persistent immunosuppression and advanced disease stage are associated with unfavorable prognoses.

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