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J Korean Med Sci. 2013 Dec;28(12):1711-5. doi: 10.3346/jkms.2013.28.12.1711. Epub 2013 Nov 26.

Impact of combined acute rejection on BK virus-associated nephropathy in kidney transplantation.

Author information

1
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Abstract

BK virus-associated nephropathy (BKVAN) is one of the major causes of allograft dysfunction in kidney transplant (KT) patients. We compared BKVAN combined with acute rejection (BKVAN/AR) with BKVAN alone in KT patients. We retrospectively analyzed biopsy-proven BKVAN in KT patients from 2000 to 2011 at Seoul National University Hospital. Among 414 biopsies from 951 patients, biopsy-proven BKVAN was found in 14 patients. Nine patients had BKVAN alone, while 5 patients had both BKVAN and acute cellular rejection. BKVAN in the BKVAN alone group was detected later than in BKVAN/AR group (21.77 vs 6.39 months after transplantation, P=0.03). Serum creatinine at diagnosis was similar (2.09 vs 2.00 mg/dL). Histological grade was more advanced in the BKVAN/AR group (P=0.034). Serum load of BKV, dose of immunosuppressants, and tacrolimus level showed a higher tendency in the BKVAN alone group; however it was not statistically significant. After anti-rejection therapy, immunosuppression was reduced in the BKVAN/AR group. Renal functional deterioration over 1 yr after BKVAN diagnosis was similar between the two groups (P=0.665). These findings suggest that the prognosis of BKVAN/AR after anti-rejection therapy followed by anti-BKV therapy might be similar to that of BKVAN alone after anti-BKV therapy.

KEYWORDS:

Acute Rejection; BK Virus; Kidney Diseases; Kidney Transplantation

PMID:
24339698
PMCID:
PMC3857364
DOI:
10.3346/jkms.2013.28.12.1711
[Indexed for MEDLINE]
Free PMC Article

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