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BK Virus Nephropathy: Prevalence, Impact and Management Strategies.
Rajeev Sharma1,2, Mareena Zachariah3
1School of Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA.
International Journal of Nephrology and Renovascular Disease
|August 22, 2020
Summary
BK virus reactivation post-renal transplant can lead to nephropathy and graft loss. Managing this requires careful immunosuppression reduction, balancing viral control with rejection risk.
Area of Science:
- Nephrology
- Virology
- Immunology
Background:
- BK virus (BKV) reactivation is a significant complication after renal transplantation, often triggered by therapeutic immunosuppression.
- This reactivation can lead to BKV nephropathy (BKVN), a major cause of renal allograft dysfunction and loss.
- Managing BKV reactivation presents a complex clinical challenge with varied treatment strategies.
Purpose of the Study:
- To review the current understanding and reported management options for BK polyomavirus nephropathy following renal transplantation.
- To highlight the diagnostic and therapeutic challenges associated with BKV reactivation in transplant recipients.
Main Methods:
- Literature review of management options and practices for BK polyomavirus nephropathy.
- Discussion of diagnostic surveillance using quantitative polymerase chain reaction (qPCR) for viral DNA in blood.
- Analysis of treatment strategies, focusing on immunosuppression reduction.
Main Results:
- Early diagnosis and monitoring rely on quantitative PCR for BK virus DNA in blood.
- Reduction of immunosuppression is the primary management strategy for BKV nephropathy.
- While effective for viral control, immunosuppression reduction carries a risk of acute graft rejection.
Conclusions:
- BK polyomavirus nephropathy is a serious post-transplant complication requiring vigilant monitoring and management.
- Balancing the need to control viral replication with the risk of allograft rejection is critical.
- Further research into optimal management strategies is warranted to improve outcomes for renal transplant recipients.
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