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Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case–control study
BACKGROUND: Following kidney transplantation, BK virus associated nephropathy (BKVN) occurs in 1 to 10% of kidney transplant recipients (KTR) and represents a major cause of graft loss. We aim at identifying factors associated with biopsy proven BKVN among KTR. METHODS: We conducted a retrospective...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9903532/ https://www.ncbi.nlm.nih.gov/pubmed/36747162 http://dx.doi.org/10.1186/s12879-023-08043-z |
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author | Gras, Julien Le Flécher, Arnaud Dupont, Axelle Vérine, Jérôme Amara, Ali Delaugerre, Constance Molina, Jean Michel Peraldi, Marie Noëlle |
author_facet | Gras, Julien Le Flécher, Arnaud Dupont, Axelle Vérine, Jérôme Amara, Ali Delaugerre, Constance Molina, Jean Michel Peraldi, Marie Noëlle |
author_sort | Gras, Julien |
collection | PubMed |
description | BACKGROUND: Following kidney transplantation, BK virus associated nephropathy (BKVN) occurs in 1 to 10% of kidney transplant recipients (KTR) and represents a major cause of graft loss. We aim at identifying factors associated with biopsy proven BKVN among KTR. METHODS: We conducted a retrospective case–control study including all KTR with a biopsy-proven diagnosis of BKVN between 2005 and 2019. Clinical characteristics and outcome were described. For each case, one control KTR without BKV infection was identified and matched by age, transplant date, and donor status. Factors associated with BKVN diagnosis were identified using exact conditional logistic regression. Comparative survival was described using Kaplan–Meier estimator. RESULTS: Sixty-four cases of BKVN were identified among 1737 new kidney transplantation (3.7% prevalence). Clinical characteristics did not differ between groups, except for a higher c-PRA among cases. BKVN occurred in a median time of 11 (5–14.5) months after KT, and was associated with a significantly impaired graft function at diagnosis. Following BKVN, 61 (95%) of the patients had immunosuppression reduction, which led to BKV DNAemia resolution in 49% of cases. In multivariate analysis, factors associated with BKVN diagnosis were lymphopenia < 500/mm(3) and a prednisone dose > 7.5 mg/day. Median duration of follow-up was 40 months for both groups. BKVN was associated with a significantly increased risk of graft rejection (P = 0.02) and return to dialysis (P = 0.01). CONCLUSIONS: BKVN remains a severe complication in KTR and is associated with an increased risk for acute rejection and return to dialysis. Lymphopenia below 500/mm(3) and corticosteroid maintenance therapy are significantly associated with biopsy-proven BKVN diagnosis. |
format | Online Article Text |
id | pubmed-9903532 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-99035322023-02-08 Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case–control study Gras, Julien Le Flécher, Arnaud Dupont, Axelle Vérine, Jérôme Amara, Ali Delaugerre, Constance Molina, Jean Michel Peraldi, Marie Noëlle BMC Infect Dis Research BACKGROUND: Following kidney transplantation, BK virus associated nephropathy (BKVN) occurs in 1 to 10% of kidney transplant recipients (KTR) and represents a major cause of graft loss. We aim at identifying factors associated with biopsy proven BKVN among KTR. METHODS: We conducted a retrospective case–control study including all KTR with a biopsy-proven diagnosis of BKVN between 2005 and 2019. Clinical characteristics and outcome were described. For each case, one control KTR without BKV infection was identified and matched by age, transplant date, and donor status. Factors associated with BKVN diagnosis were identified using exact conditional logistic regression. Comparative survival was described using Kaplan–Meier estimator. RESULTS: Sixty-four cases of BKVN were identified among 1737 new kidney transplantation (3.7% prevalence). Clinical characteristics did not differ between groups, except for a higher c-PRA among cases. BKVN occurred in a median time of 11 (5–14.5) months after KT, and was associated with a significantly impaired graft function at diagnosis. Following BKVN, 61 (95%) of the patients had immunosuppression reduction, which led to BKV DNAemia resolution in 49% of cases. In multivariate analysis, factors associated with BKVN diagnosis were lymphopenia < 500/mm(3) and a prednisone dose > 7.5 mg/day. Median duration of follow-up was 40 months for both groups. BKVN was associated with a significantly increased risk of graft rejection (P = 0.02) and return to dialysis (P = 0.01). CONCLUSIONS: BKVN remains a severe complication in KTR and is associated with an increased risk for acute rejection and return to dialysis. Lymphopenia below 500/mm(3) and corticosteroid maintenance therapy are significantly associated with biopsy-proven BKVN diagnosis. BioMed Central 2023-02-06 /pmc/articles/PMC9903532/ /pubmed/36747162 http://dx.doi.org/10.1186/s12879-023-08043-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Gras, Julien Le Flécher, Arnaud Dupont, Axelle Vérine, Jérôme Amara, Ali Delaugerre, Constance Molina, Jean Michel Peraldi, Marie Noëlle Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case–control study |
title | Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case–control study |
title_full | Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case–control study |
title_fullStr | Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case–control study |
title_full_unstemmed | Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case–control study |
title_short | Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case–control study |
title_sort | characteristics, risk factors and outcome of bkv nephropathy in kidney transplant recipients: a case–control study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9903532/ https://www.ncbi.nlm.nih.gov/pubmed/36747162 http://dx.doi.org/10.1186/s12879-023-08043-z |
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