Long-term prognosis of BK virus-associated nephropathy in kidney transplant recipients
Background : The long-term prognosis of BK virus-associated nephropathy (BKVAN) in kidney transplant recipients (KTRs) is uncertain. We evaluated the long-term prognosis in KTRs with BKVAN and the clinical significance of BKVAN on post-transplant clinical outcome. Methods : We retrospectively analyz...
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2018-06-01
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| Series: | Kidney Research and Clinical Practice |
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| Online Access: | https://doi.org/10.23876/j.krcp.2018.37.2.167 |
| _version_ | 1818017335620927488 |
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| author | Woo Yeong Park Seong Sik Kang Kyubok Jin Sung Bae Park Misun Choe Seungyeup Han |
| author_facet | Woo Yeong Park Seong Sik Kang Kyubok Jin Sung Bae Park Misun Choe Seungyeup Han |
| author_sort | Woo Yeong Park |
| collection | DOAJ |
| description | Background : The long-term prognosis of BK virus-associated nephropathy (BKVAN) in kidney transplant recipients (KTRs) is uncertain. We evaluated the long-term prognosis in KTRs with BKVAN and the clinical significance of BKVAN on post-transplant clinical outcome. Methods : We retrospectively analyzed the medical records of 582 patients who underwent kidney transplant (KT) between 2001 and 2014. We divided the patients into a BKVAN group (15 patients) diagnosed by allograft biopsy and a control group (356 patients). Results : The incidence of BKVAN was 4.0%, and the mean follow-up duration was 93.1 ± 52.3 months. Median time from KT to BKVAN diagnosis was 5.9 months (interquartile range [IQR], 4.4-8.7). In the BKVAN group, 9 (60.0%) KTRs with combined acute rejection progressed to graft failure, and the median time from BKVAN diagnosis to graft failure was 36.2 months (IQR, 9.7-65.5). Death-censored graft survival rate and patient survival rate in the BKVAN group were significantly lower than those in the control group. BKVAN and rejection were independent risk factors for graft failure. In the subgroup analysis, death-censored graft survival rate of KTRs with BKVAN with acute rejection was significantly worst in comparison with similar patients without BKVAN regardless of acute rejection (P ＜ 0.001). Conclusion : The long-term prognosis of BKVAN with acute rejection was very poor because of graft failure caused by inadequate treatment for acute rejection considering BKVAN. Therefore, we should carefully monitor the allograft status of KTRs through regular surveillance tests after treatment for BKVAN with acute rejection. |
| first_indexed | 2024-04-14T07:25:44Z |
| format | Article |
| id | doaj.art-b8a80d5e387c41a48466800e3818f105 |
| institution | Directory Open Access Journal |
| issn | 2211-9132 |
| language | English |
| last_indexed | 2024-04-14T07:25:44Z |
| publishDate | 2018-06-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-b8a80d5e387c41a48466800e3818f1052022-12-22T02:06:02ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322018-06-0137216717310.23876/j.krcp.2018.37.2.167j.krcp.2018.37.2.167Long-term prognosis of BK virus-associated nephropathy in kidney transplant recipientsWoo Yeong Park0Seong Sik Kang1Kyubok Jin2Sung Bae Park3Misun Choe4Seungyeup Han5Department of Internal Medicine, Keimyung University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Keimyung University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Keimyung University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Keimyung University School of Medicine, Daegu, KoreaDepartment of Pathology, Keimyung University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Keimyung University School of Medicine, Daegu, KoreaBackground : The long-term prognosis of BK virus-associated nephropathy (BKVAN) in kidney transplant recipients (KTRs) is uncertain. We evaluated the long-term prognosis in KTRs with BKVAN and the clinical significance of BKVAN on post-transplant clinical outcome. Methods : We retrospectively analyzed the medical records of 582 patients who underwent kidney transplant (KT) between 2001 and 2014. We divided the patients into a BKVAN group (15 patients) diagnosed by allograft biopsy and a control group (356 patients). Results : The incidence of BKVAN was 4.0%, and the mean follow-up duration was 93.1 ± 52.3 months. Median time from KT to BKVAN diagnosis was 5.9 months (interquartile range [IQR], 4.4-8.7). In the BKVAN group, 9 (60.0%) KTRs with combined acute rejection progressed to graft failure, and the median time from BKVAN diagnosis to graft failure was 36.2 months (IQR, 9.7-65.5). Death-censored graft survival rate and patient survival rate in the BKVAN group were significantly lower than those in the control group. BKVAN and rejection were independent risk factors for graft failure. In the subgroup analysis, death-censored graft survival rate of KTRs with BKVAN with acute rejection was significantly worst in comparison with similar patients without BKVAN regardless of acute rejection (P ＜ 0.001). Conclusion : The long-term prognosis of BKVAN with acute rejection was very poor because of graft failure caused by inadequate treatment for acute rejection considering BKVAN. Therefore, we should carefully monitor the allograft status of KTRs through regular surveillance tests after treatment for BKVAN with acute rejection.https://doi.org/10.23876/j.krcp.2018.37.2.167BK virusGraft survivalKidney transplantationPrognosisRejection |
| spellingShingle | Woo Yeong Park Seong Sik Kang Kyubok Jin Sung Bae Park Misun Choe Seungyeup Han Long-term prognosis of BK virus-associated nephropathy in kidney transplant recipients Kidney Research and Clinical Practice BK virus Graft survival Kidney transplantation Prognosis Rejection |
| title | Long-term prognosis of BK virus-associated nephropathy in kidney transplant recipients |
| title_full | Long-term prognosis of BK virus-associated nephropathy in kidney transplant recipients |
| title_fullStr | Long-term prognosis of BK virus-associated nephropathy in kidney transplant recipients |
| title_full_unstemmed | Long-term prognosis of BK virus-associated nephropathy in kidney transplant recipients |
| title_short | Long-term prognosis of BK virus-associated nephropathy in kidney transplant recipients |
| title_sort | long term prognosis of bk virus associated nephropathy in kidney transplant recipients |
| topic | BK virus Graft survival Kidney transplantation Prognosis Rejection |
| url | https://doi.org/10.23876/j.krcp.2018.37.2.167 |
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