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Determination of viremia cut‐off for risk to develop BKP yV‐associated nephropathy among kidney transplant recipients
Author(s) -
Bicalho Camila Silva,
Oliveira Renato dos Reis,
David Daísa Ribeiro,
Fink Maria Cristina Domingues Silva,
Agena Fabiana,
Castro Maria Cristina,
Panutti Cláudio,
DavidNeto Elias,
Pierrotti Ligia Camera
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12969
Subject(s) - viremia , medicine , nephropathy , kidney transplantation , transplantation , viral load , immunology , virology , gastroenterology , virus , endocrinology , diabetes mellitus
Background BK polyomavirus ( BKP yV)‐associated nephropathy ( BKP y VAN ) is a consequence of BKP yV replication in the urinary tract in kidney transplant recipients ( KTR ). Objectives The objectives were to determine the prevalence of BKP yV replication and BKP y VAN , risk factors associated to sustained viremia and BKP y VAN , and viremia cut‐off that best predict the occurrence of sustained viremia and nephropathy in KTR of a single University Hospital Kidney Transplant Center. Patients and Methods All KTR undergoing transplantation from August 2010 to December 2011 were enrolled and monitored up to 2 years posttransplantation for BKP yV viruria by decoy cells shedding or polymerase chain reaction ( PCR ) and viremia by PCR . Kidney biopsy was indicated if sustained viremia (two or more viremia above 10 000 copies/mL) to confirm BKP y VAN diagnosis. Results In this study, 326 transplants were performed and 246 patients were included. Prevalence of viruria was 36.9%, viremia 22.3% and nephropathy 3.2%. Male gender was the only risk factor associated to sustained viremia or nephropathy. Cut‐off value of viremia that best discriminates the progression to sustained viremia and to BKP y VAN was 37 488 and 44 956 copies/mL, respectively. Conclusions Prevalence of viruria, viremia, and nephropathy were similar to those reported in literature but the cut‐off value of viremia that best discriminates the risk of progression to nephropathy was greater than the value usually reported, which is 10 000 copies/mL.