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Higher Incidence of BK Virus Nephropathy in Pediatric Kidney Allograft Recipients with Alport Syndrome

A retrospective review was performed to assess the risk factors and outcomes of BK virus infection and nephropathy (BKVN), an early complication in pediatric kidney allograft recipients. The study investigated the incidence, risk factors, and clinical outcomes of BK viremia and BKVN in a Korean popu...

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Autores principales: Cho, Young Hoon, Hyun, Hye Sun, Park, Eujin, Moon, Kyung Chul, Min, Sang-Il, Ha, Jongwon, Ha, Il-Soo, Cheong, Hae Il, Ahn, Yo Han, Kang, Hee Gyung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517952/
https://www.ncbi.nlm.nih.gov/pubmed/30978953
http://dx.doi.org/10.3390/jcm8040491
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author Cho, Young Hoon
Hyun, Hye Sun
Park, Eujin
Moon, Kyung Chul
Min, Sang-Il
Ha, Jongwon
Ha, Il-Soo
Cheong, Hae Il
Ahn, Yo Han
Kang, Hee Gyung
author_facet Cho, Young Hoon
Hyun, Hye Sun
Park, Eujin
Moon, Kyung Chul
Min, Sang-Il
Ha, Jongwon
Ha, Il-Soo
Cheong, Hae Il
Ahn, Yo Han
Kang, Hee Gyung
author_sort Cho, Young Hoon
collection PubMed
description A retrospective review was performed to assess the risk factors and outcomes of BK virus infection and nephropathy (BKVN), an early complication in pediatric kidney allograft recipients. The study investigated the incidence, risk factors, and clinical outcomes of BK viremia and BKVN in a Korean population of pediatric patients who received renal transplantation from 2001–2015 at the Seoul National University Hospital. BKVN was defined as biopsy-proven BKVN or plasma BK viral loads >10,000 copies/mL for >3 weeks. BK viremia was defined as a BK viral load >100 copies/mL in blood. Among 168 patients assessed for BK virus status, 30 patients (17.9%) tested positive for BK viremia at a median of 12.6 months after transplantation. BKVN was diagnosed in six patients (3.6%) at a median of 13.4 months after transplantation. Three of the six BKVN patients had Alport syndrome (p = 0.003), despite this disease comprising only 6% of the study population. Every patient with BK viremia and Alport syndrome developed BKVN, while only 11.1% of patients with BK viremia progressed to BKVN in the absence of Alport syndrome. Multivariate analysis revealed that Alport syndrome was associated with BKVN development (hazard ratio 13.2, p = 0.002). BKVN treatment included the reduction of immunosuppression, leflunomide, and intravenous immunoglobulin. No allografts were lost in the two years following the diagnosis of BKVN. In summary, the incidence of BKVN in pediatric kidney allograft recipients was similar to findings in previous reports, but was higher in patients with underlying Alport syndrome.
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spelling pubmed-65179522019-05-31 Higher Incidence of BK Virus Nephropathy in Pediatric Kidney Allograft Recipients with Alport Syndrome Cho, Young Hoon Hyun, Hye Sun Park, Eujin Moon, Kyung Chul Min, Sang-Il Ha, Jongwon Ha, Il-Soo Cheong, Hae Il Ahn, Yo Han Kang, Hee Gyung J Clin Med Article A retrospective review was performed to assess the risk factors and outcomes of BK virus infection and nephropathy (BKVN), an early complication in pediatric kidney allograft recipients. The study investigated the incidence, risk factors, and clinical outcomes of BK viremia and BKVN in a Korean population of pediatric patients who received renal transplantation from 2001–2015 at the Seoul National University Hospital. BKVN was defined as biopsy-proven BKVN or plasma BK viral loads >10,000 copies/mL for >3 weeks. BK viremia was defined as a BK viral load >100 copies/mL in blood. Among 168 patients assessed for BK virus status, 30 patients (17.9%) tested positive for BK viremia at a median of 12.6 months after transplantation. BKVN was diagnosed in six patients (3.6%) at a median of 13.4 months after transplantation. Three of the six BKVN patients had Alport syndrome (p = 0.003), despite this disease comprising only 6% of the study population. Every patient with BK viremia and Alport syndrome developed BKVN, while only 11.1% of patients with BK viremia progressed to BKVN in the absence of Alport syndrome. Multivariate analysis revealed that Alport syndrome was associated with BKVN development (hazard ratio 13.2, p = 0.002). BKVN treatment included the reduction of immunosuppression, leflunomide, and intravenous immunoglobulin. No allografts were lost in the two years following the diagnosis of BKVN. In summary, the incidence of BKVN in pediatric kidney allograft recipients was similar to findings in previous reports, but was higher in patients with underlying Alport syndrome. MDPI 2019-04-11 /pmc/articles/PMC6517952/ /pubmed/30978953 http://dx.doi.org/10.3390/jcm8040491 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cho, Young Hoon
Hyun, Hye Sun
Park, Eujin
Moon, Kyung Chul
Min, Sang-Il
Ha, Jongwon
Ha, Il-Soo
Cheong, Hae Il
Ahn, Yo Han
Kang, Hee Gyung
Higher Incidence of BK Virus Nephropathy in Pediatric Kidney Allograft Recipients with Alport Syndrome
title Higher Incidence of BK Virus Nephropathy in Pediatric Kidney Allograft Recipients with Alport Syndrome
title_full Higher Incidence of BK Virus Nephropathy in Pediatric Kidney Allograft Recipients with Alport Syndrome
title_fullStr Higher Incidence of BK Virus Nephropathy in Pediatric Kidney Allograft Recipients with Alport Syndrome
title_full_unstemmed Higher Incidence of BK Virus Nephropathy in Pediatric Kidney Allograft Recipients with Alport Syndrome
title_short Higher Incidence of BK Virus Nephropathy in Pediatric Kidney Allograft Recipients with Alport Syndrome
title_sort higher incidence of bk virus nephropathy in pediatric kidney allograft recipients with alport syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517952/
https://www.ncbi.nlm.nih.gov/pubmed/30978953
http://dx.doi.org/10.3390/jcm8040491
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