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Biopsy-Proven BK Virus-Associated Nephropathy: Clinico-Pathologic Correlations
Sarah Jahdali1, Noura Al Oudah, Khaled O Alsaad
1From the King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Summary
Risk factors for BK virus nephropathy include antithymocyte globulin and lower weight. Early acyclovir prophylaxis may reduce risk. Older patients and deceased donor kidney recipients had better graft survival in BK nephropathy.
Area of Science:
- Nephrology
- Virology
- Transplantation Immunology
Background:
- BK virus nephropathy is a significant complication after kidney transplantation.
- Understanding clinico-pathologic correlations is crucial for managing outcomes.
Purpose of the Study:
- To investigate the clinico-pathologic correlations in BK virus nephropathy.
- To compare outcomes of BK virus-positive patients with BK virus-negative patients experiencing graft rejection.
Main Methods:
- Retrospective study of biopsy-proven polyoma (BK) virus infection.
- Comparison of survival and renal outcomes between BK virus-positive and negative groups.
- Histopathologic characterization by a blinded nephropathologist.
Main Results:
- BK nephropathy identified in 10 patients with graft dysfunction.
- Higher incidence of antithymocyte globulin induction in BK-positive patients.
- Similar graft survival rates (70% vs 68%) between BK-positive and negative groups after 6.8 years.
- Better graft survival in older patients and those with deceased donor kidney grafts within the BK group.
- No significant impact of histopathologic features on renal prognosis.
Conclusions:
- Antithymocyte globulin use, lower patient weight, and lack of early acyclovir prophylaxis are risk factors for BK nephropathy.
- Older age and deceased donor kidney grafts are associated with better graft survival in BK nephropathy.
- Viral load and nephropathy stage did not influence graft survival in this cohort.
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