JCV viruria associates with suboptimal recovery of kidney function three years after living kidney donation

Area of Science:

• Nephrology
• Transplantation Immunology
• Virology

Background:

• Limited research exists on pre-donation factors influencing renal recovery post-living kidney donation (LKD).
• Investigating pre-donation John Cunningham virus (JCV) infection as a potential factor affecting kidney function after LKD.

Purpose of the Study:

• To retrospectively analyze pre-donation factors, including JCV infection, on kidney function decline after LKD.
• To assess the impact of JCV on compensatory hypertrophy and long-term estimated glomerular filtration rate (eGFR) post-donation.

Main Methods:

• Evaluated urine JCV viral loads, eGFR, and blood pressure in 60 living kidney donors pre-donation.
• Defined suboptimal compensatory hypertrophy as post-donation eGFR <60% of pre-donation eGFR.
• Followed donors for 3.2±1.6 years, analyzing eGFR at multiple time points.

Main Results:

• No association found between age, gender, or hypertension and post-donation eGFR decline.
• 40% of LK donors were infected with JCV.
• Mean eGFR recovery at year 3 was significantly lower in JCV-infected donors (61.8%) versus non-infected donors (71.0%, p=0.006).

Conclusions:

• JCV infection may negatively impact renal recovery after LKD.
• Hypothesized JCV might alter glomerular hyperfiltration states pre- or post-nephrectomy.
• Further long-term studies are required to confirm JCV's effect on sustained eGFR and its role in kidney adaptation.