Open AccessBright Field Microscopy to Detect Decoy Cells Due to BK Virus Infection in the Fresh and Unstained Urine Sediment in Kidney Allograft Recipients
Author(s) -
Poloni José A. T.,
Pinto Gabriel G.,
Giordani Maria S. B.,
Keitel Elizete,
Inocente Nadiana,
Voegeli Carlos F.,
Fogazzi Giovanni B.,
Pasqualotto Alessandro C.,
Rotta Liane N.
Publication year - 2016
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.21978
Subject(s) - decoy , urine , bk virus , kidney , urinary sediment , chemistry , virology , medicine , kidney transplantation , receptor
Background BK virus ( BKV ) may reactivate in kidney allograft recipients ultimately leading to BKV nephropathy and graft loss. Decoy cells ( DC s) are one of the early marks of BKV reactivation, and these can be detected in the urine sediment. Methods A cohort of 102 kidney transplant patients was followed during months 3 and 6 after the transplant procedure. Urine samples were obtained to detect the presence of DC in the fresh and unstained urine sediment under bright field microscopy ( BFM ), in concomitance to the determination of the amount of BK viruria by qPCR . Results Decoy cells were found in 14.7% of patients (15/102). There was a strong agreement ( P < 0.001) between qualitative DC detection by two experienced analysts and by qPCR . The positive predictive value, negative predictive value, specificity, and accuracy of BFM were 80%, 75%, 97%, and 75%, respectively. Test sensitivity was 16%. The comparative method was the qPCR . Conclusions Despite its limited sensitivity, BFM of unstained urine sediment is an easily available, fast and cheap method to identify DC s in the population of kidney allograft recipients. The diagnostic performance of BFM on the hands of less experienced analysts deserves further investigation.