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BK Virus Nephropathy in Kidney Transplantation: An Approach Proposal and Update on Risk Factors, Diagnosis, and
S Gonzalez1, D P Escobar-Serna1, O Suarez1
1Organ and Tissues Transplant Group, Surgery Department, Medical School, National University of Colombia, Bogotá, Colombia.
Abstract:
BK virus belongs to Polyomaviridae family; it causes 95% of nephropathy cases related to polyomavirus, with the other 5% caused by JC virus. Nephropathy jeopardizes graft function, causing a premature failure of the graft in 1%-10% of patients with kidney transplants. Nowadays, antiviral effective treatment is unknown, which is why blood and urine screening of renal transplantation patients has become the most important recommendation to guide the decrease of immunosuppression, and the only proven method to decrease poor outcomes. Different interventions, such as cidofovir, leflunomide, fluoroquinolones, and intravenous immunoglobulin, have been attempted with no improvement at all. This review aims to summarize the most relevant features of BK virus, historical issues, transmission mechanisms, risk factors, and therapeutic interventions.
Insights
BK virus causes most polyomavirus-related nephropathy in kidney transplant patients. Early screening and reduced immunosuppression are key, as effective antiviral treatments are lacking.
Area of Science:
- Nephrology
- Virology
- Immunology
Background:
- BK virus (BKV) is a polyomavirus responsible for 95% of polyomavirus-associated nephropathy (PVAN).
- PVAN significantly impacts kidney graft function, leading to premature graft failure in 1%-10% of kidney transplant recipients.
- JC virus accounts for the remaining 5% of PVAN cases.
Purpose of the Study:
- To review the key features of BK virus, including its history and transmission.
- To summarize current understanding of risk factors associated with BK virus infection.
- To discuss various therapeutic interventions attempted for BK virus nephropathy.
Main Methods:
- This review synthesizes information from existing literature on BK virus and related nephropathy.
- It examines historical data, transmission routes, and identified risk factors.
- The review analyzes outcomes of different therapeutic strategies.
Main Results:
- No effective antiviral treatments are currently available for BK virus nephropathy.
- Screening of blood and urine for BKV is crucial for early detection in renal transplant patients.
- Reducing immunosuppression is the primary strategy to manage BKV and improve outcomes.
Conclusions:
- BK virus nephropathy poses a significant threat to kidney transplant recipients.
- Early detection through regular screening and prompt management by decreasing immunosuppression are vital.
- Further research into effective antiviral therapies is urgently needed.
