June 21, 2013

Screening for BK Viremia Reduces But Does Not Eliminate the Risk of BK Nephropathy: A Single-Center Retrospective Analysis


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BK nephropathy is an important cause of graft loss and the majority of kidney transplant centers perform plasma BK virus screening. The purpose of screening is to detect virus early so that pre-emptive measures such as reduction of immunosuppression can be employed, thereby preventing progression to nephropathy. Knight et al. reviewed 369 kidney transplant recipients that were screened for BK viremia. In all, 16% of patients became viremic and 4 had graft loss due to BK nephropathy. Immunosuppression was reduced and cidofovir was used for BK nephropathy. Grafts that were BK positive fared worse than BK-negative grafts. Estimated GFR in the BK positive group was lower than the BK negative group. This study suggests that screening may reduce the incidence of BK nephropathy but BK positivity itself is a risk for graft dysfunction. Therefore, it may be more important to prevent BK viremia.

Renal Transplantation, Transplant Infectious Disease

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