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Acute Kidney Injury and BK Polyomavirus in Urine Sediment Cells
Sahra Pajenda1, Daniela Anna Gerges1, Raimundo Freire2,3,4
1Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, 1090 Vienna, Austria.
International Journal of Molecular Sciences
|December 23, 2023
Summary
BK polyomavirus (BKV) replication in urine sediment cells can be detected non-invasively during acute kidney injury (AKI). This method aids in identifying kidney transplant recipients at risk for BK virus-associated nephropathy (BKPyVAN) and viremia.
Area of Science:
- Virology
- Nephrology
- Immunology
Background:
- BK polyomavirus (BKV) is common in immunosuppressed individuals, particularly kidney transplant recipients.
- BKV infection can lead to BK virus-associated nephropathy (BKPyVAN) and hemorrhagic cystitis.
- Current diagnostics include PCR, immunohistochemistry, and detection of decoy cells, but non-invasive methods for BKV replication assessment are needed.
Purpose of the Study:
- To evaluate a non-invasive method for detecting BK polyomavirus replication in urine sediment cells of patients with acute kidney injury (AKI).
- To assess the utility of this method in identifying kidney transplant recipients (KTX) at risk for BKV-related complications.
- To compare BKV detection in KTX and non-kidney transplanted (nonKTX) patients with AKI.
Main Methods:
- RNA extraction, reverse transcription, and virus-specific qPCR were used to detect BKV replication in urine sediment cells from 79 patients with AKI.
- Immunofluorescence staining for VP1 BKV protein was performed using confocal microscopy.
- Patients were categorized based on kidney transplant history (KTX vs. nonKTX) and AKI stage.
Main Results:
- BK virus replication was detected in urine sediment cells of 22 patients with AKI (11 KTX, 11 nonKTX).
- BKV copies were more frequent in patients with AKI stage III.
- Higher BKV copy numbers were observed in KTX patients with a history of or current BKPyVAN. Decoy cells were only found in KTX patients with BKPyVAN.
Conclusions:
- Non-invasive detection of BKV replication in urine sediment cells is feasible during AKI.
- This method can identify KTX patients at risk for viremia and BKPyVAN.
- This approach may serve as a valuable screening tool for monitoring and guiding immunosuppression in KTX patients experiencing AKI.
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