In:
Transplant Infectious Disease, Wiley, Vol. 20, No. 6 ( 2018-12)
Abstract:
Polyomavirus‐associated nephropathy is associated with high risk of kidney allograft loss. Whether the cause of native end‐stage renal disease influences the risk of BK infection is unclear. Methods A retrospective, single‐center study of 2741 adult kidney transplant recipients between 1994 and 2014 was performed. Recipients had end‐stage renal disease due to polycystic kidney disease ( PKD , n = 549), diabetes mellitus ( DM , n = 947), hypertension ( HTN , n = 442), or glomerulonephritis ( GN , n = 803). Results A total of 327 recipients (12%) developed post‐transplant BK viremia over a median follow‐up time of 5 years. The incidence rate of BK viremia was lowest in patients with PKD (1.46 per 100 person‐years) compared to other causes of ESRD ( DM = 2.06, HTN = 2.65, and GN = 2.01 per 100 person‐years). A diagnosis of PKD was associated with a lower risk of post‐transplant BK viremia (adjusted HR (95% CI ) = 0.67 (0.48‐0.95), P = 0.02). BK nephropathy was significantly less common in patients with PKD (0.21 per 100 person‐years) compared to those with HTN (0.80 per 100 person‐years, P ≤ 0.001). Among patients with PKD , the risk of BK viremia was lower in patients with nephrectomy, compared to those without nephrectomy (adjusted HR (95% CI ) = 0.42 (0.19‐0.92), P 〈 0.05). Conclusion ESRD due to PKD is associated with a lower risk of post‐transplant BK infection. The renal tubular epithelial cells in PKD are unique; they are in a proliferative but non‐differentiated state. Whether this characteristic of renal tubular epithelial cells alters the BK viral reservoir or replication in PKD patients warrants further study.
Type of Medium:
Online Resource
ISSN:
1398-2273
,
1399-3062
DOI:
10.1111/tid.2018.20.issue-6
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2010983-0
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