Impact of low‐level <scp>BK</scp> polyomavirus viremia on intermediate‐term renal allograft function

Korth, Johannes; Widera, Marek; Dolff, Sebastian; Guberina, Hana; Bienholz, Anja; Brinkhoff, Alexandra; Anastasiou, Olympia E.; Kribben, Andreas; Dittmer, Ulf; Verheyen, Jens; Wilde, Benjamin; Witzke, Oliver

doi:10.1111/tid.12817

Cited by 18 publications

(23 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is no clear definition that decreasing IS and clearing the virus will prevent the allograft kidney from an injury and a dimin- Interestingly, the delta eGFR they found was exactly the same we found in this study. 24 Our findings indicate that controlling viremia to low levels will not result in irreversible allograft damage. However, to decrease the immunosuppression cause a fear of developing rejection, although others have shown that an 80% or more decrease in viremia resulted in a fast viremia clearance 33 without increasing the incidence of acute rejection.…”

Section: Discussionmentioning

confidence: 66%

“…Our patients presented a high incidence of viremia (51%) compared to others who report 19% to 42% . The viremia incidence may vary if one routinely collects viremia, as we did, from the second to the 12th month, or only collect viremia if urinary decoy cells are positive …”

Section: Discussionmentioning

confidence: 99%

“…Korth et al, recently showed similar results as in this study. In their series, low‐levels of BK viremia did not result on intermediate (44 months) renal dysfunction whereas high‐level of viremia did . Interestingly, the delta eGFR they found was exactly the same we found in this study …”

Section: Discussionmentioning

confidence: 99%

“…12 We excluded, re-transplants, Our patients presented a high incidence of viremia (51%) compared to others who report 19% 15 to 42%. 23,24 The viremia incidence may vary if one routinely collects viremia, as we did, from the second to the 12th month, or only collect viremia if urinary decoy cells are positive. 15 The majority of our patients were under TAC/MPA immunosuppression (IS) and 38% received induction with ATG.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of polyoma viremia on 3‐year allograft kidney function

David‐Neto

Agena

David

et al. 2019

Transplant Infectious Dis

View full text Add to dashboard Cite

Background Polyoma viremia is associated with damage to renal tubular and urothelial cells. This may imply that a certain level of viremia, even cleared thereafter, could be associated with long‐term renal dysfunction. Methods We, retrospectively, analyzed 390 first renal transplants adult recipients (≥18 years) who were monitored for BK viremia in the first 12 months and evaluated estimated GFR (MDRD‐4 equation) at 1 month and at the last follow‐up (959 ± 392 days). Results One hundred and ninety‐nine patients (51%) developed at least one positive viremia: 105 (53%) low viremia (<104 copies/mL), 36 (18%) high viremia (4 × 104 > viremia ≥ 104 copies/mL) and 58 (15%) viremia (≥4 × 104 copies/mL) consistent with polyoma virus associated nephropathy (PyVAN). Out of these 58 patients, 24 (6%) developed bx‐proven (SV40+) PyVAN and 34(8.7%) presumptive PyVAN (SV40−). Baseline characteristics, immunosuppression, KDRI, rejection episodes, etc., did not differ among groups but there were more deceased donors and ATG induction therapy in the high viremia group. At last follow‐up, all patients in the low, high viremia and presumptive PyVAN (except 2) had cleared BK viremia. Bx‐proven PyVAN led to 14 graft losses, 10 due to PyVAN. In the presumptive PyVAN there was only one graft loss registered as due to PyVAN. eGFR, at 1 month after KTx, did not differ among groups (51 ± 22 vs 48 ± 24 vs 45 ± 27 vs 43 ± 18 vs 46 ± 22 mL/min/1.73 m2), for no, low and high viremia as well for presumptive PyVAN and bx‐proven PyVAN groups, respectively. At the last follow‐up, eGFR did not differ between the no, low, and high viremia compared to baseline and to each other but was statistically lower in the presumptive and bx‐proven PyVAN (38 ± 15 and 17 ± 7 mL/min/1.73 m2) either compared to baseline or to the other groups. Conclusions This study shows that low and high levels of BK viremia do not lead to GFR changes although very high viremia levels, compatible with presumptive or bx‐proven PyVAN, even if cleared thereafter, lead to allograft damage and decreased GFR.

show abstract

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of polyoma viremia on 3‐year allograft kidney function

David‐Neto

Agena

David

et al. 2019

Transplant Infectious Dis

View full text Add to dashboard Cite

show abstract

“…In a study by Drachenberg et al, a BKV level of more than 10 000 copies/mL was significantly associated with BKN. Similarly, a study by Korth et al found that low level BKV had no impact on graft function, failure, or rejection compared to patients with undetectable BKV, while high‐level BKV > 10 000 was associated with worse graft function, rejection, and higher rates of BKN. Additionally, in a small series of patients without BKN, BK viremia was not associated with a difference in graft function compared to recipients without BK viremia .…”

Section: Introductionmentioning

confidence: 92%

BK viremia is not associated with adverse outcomes in the absence of BK nephropathy

Hertz-Tang

Astor

Mandelbrot

et al. 2018

Clinical Transplantation

View full text Add to dashboard Cite

There are limited data regarding the association of different levels of BK viremia and BK nephropathy (BKN), and graft outcomes. We studied the BK plasma PCR levels of all kidney transplant recipients (KTR) transplanted at our institution between 01/01/2006 and 06/30/2014. Patients were divided into groups based on their highest BK plasma PCR level within the first year following transplantation: undetectable, low (<1000 copies/mL), moderate (1000-10 000 copies/mL), high (>10 000-100 000 copies/mL), very high (>100 000 copies/mL), and those that had biopsy-proven BKN. There were a total of 1146 KTR during the study period: 813 with undetectable BK levels and 333 with any detectable BK level (87 with low, 79 with moderate, 88 with high, 34 with very high level BK, and 45 that had BKN). Compared to KTR with an undetectable BK level, incidence of mortality, graft failure, rejections,and infections were not significantly different for those with low, moderate, high, or very high BK level. Patients with BKN had a higher rate of infection and higher rates of total graft failure or death-censored graft failure compared to those with undetectable BK levels. BK viremia in the absence of BKN does not significantly increase the risk of rejection, infections, or graft failure compared to an undetectable BK level.

show abstract

COVID-19 in der Intensivmedizin

et al. 2023

Self Cite

View full text Add to dashboard Cite

COVID-19 („coronavirus disease 2019“) kann bei immunsupprimierten Patienten trotz der Verfügbarkeit von Impfstoffen und neuen antiviralen Medikamenten einen schweren Krankheitsverlauf nehmen, welcher häufig intensivmedizinisch versorgt werden muss. Einer der Hauptgründe dafür ist die allgemein schlechtere Immunreaktion unter Immunsuppression. Umso wichtiger ist es, die Stadien der Erkrankung zu kennen und die mittlerweile verfügbaren therapeutischen Optionen entsprechend auszuwählen.

show abstract

Impact of low‐level BK polyomavirus viremia on intermediate‐term renal allograft function

Abstract: High-level viremia was associated with impaired graft function. In contrast, low-level BKPyV viremia had no significant impact on intermediate-term graft function.

Cited by 18 publications

References 31 publications

Effect of polyoma viremia on 3‐year allograft kidney function

Effect of polyoma viremia on 3‐year allograft kidney function

BK viremia is not associated with adverse outcomes in the absence of BK nephropathy

COVID-19 in der Intensivmedizin

Contact Info

Product

Resources

About