English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Polyomavirus-associated nephropathy is an important cause of allograft dysfunction and graft loss after kidney transplantation. Even if histological evaluation is the gold standard for graft study and diagnosis of polyomavirus-associated nephropathy, K-DIGO guidelines suggest performing an <em>indication biopsy</em> in selected patient’s clinical conditions or laboratory parameters. The practice of <em>protocol biopsy</em> is still controversial. We report the management of a case of presumptive polyomavirus-associated nephropathy in a 53-year-old kidney transplant recipient affected by type 1 hyperoxaluria with persistent high levels of viruria and sustained levels of polyomavirus BK viremia. The presence of a presumptive polyomavirus-associated nephropathy, even if never confirmed by biopsy, never compromised his clinical condition and allograft function. As a result of an immunosuppression-sparing policy and use of mTOR inhibitor, the polyomavirus BK viremia was successfully controlled with an observation time >5 years. The decision to perform or not a graft biopsy was the main question in the management of this case. We opted for a non-invasive approach because of the high risk of biopsy with macrohematuria on earlier biopsy in a dual kidney transplant and patient’s unwillingness for the procedure. The replication level of polyomavirus BK was significantly reduced by the decrease of immunosuppression on the basis of a close nucleic acid testing monitoring. The strategy we adopted could be considered in cases when renal biopsy is contraindicated or considered to be high risk

Persistently high-level polyomavirus BK replication in the absence of renal function abnormalities in a kidney transplant recipient