Effect of polyoma viremia on 3-year allograft kidney function

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author DAVID-NETO, Elias FMUSP-HC
DAVID, Daisa Silva Ribeiro FMUSP-HC
PAULA, Flavio Jota de FMUSP-HC
FINK, Maria Cristina Domingues FMUSP-HC
AZEVEDO, Luiz Sergio Fonseca de FMUSP-HC
dc.date.issued 2019
dc.identifier.citation TRANSPLANT INFECTIOUS DISEASE, v.21, n.2, article ID e13056, 9p, 2019
dc.identifier.issn 1398-2273
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/31896
dc.description.abstract Background Polyoma viremia is associated with damage to renal tubular and urothelial cells. This may imply that a certain level of viremia, even cleared thereafter, could be associated with long-term renal dysfunction. Methods We, retrospectively, analyzed 390 first renal transplants adult recipients (>= 18 years) who were monitored for BK viremia in the first 12 months and evaluated estimated GFR (MDRD-4 equation) at 1 month and at the last follow-up (959 +/- 392 days). Results One hundred and ninety-nine patients (51%) developed at least one positive viremia: 105 (53%) low viremia (<10(4) copies/mL), 36 (18%) high viremia (4 x 10(4) > viremia >= 10(4) copies/mL) and 58 (15%) viremia (>= 4 x 10(4) copies/mL) consistent with polyoma virus associated nephropathy (PyVAN). Out of these 58 patients, 24 (6%) developed bx-proven (SV40+) PyVAN and 34(8.7%) presumptive PyVAN (SV40-). Baseline characteristics, immunosuppression, KDRI, rejection episodes, etc., did not differ among groups but there were more deceased donors and ATG induction therapy in the high viremia group. At last follow-up, all patients in the low, high viremia and presumptive PyVAN (except 2) had cleared BK viremia. Bx-proven PyVAN led to 14 graft losses, 10 due to PyVAN. In the presumptive PyVAN there was only one graft loss registered as due to PyVAN. eGFR, at 1 month after KTx, did not differ among groups (51 +/- 22 vs 48 +/- 24 vs 45 +/- 27 vs 43 +/- 18 vs 46 +/- 22 mL/min/1.73 m(2)), for no, low and high viremia as well for presumptive PyVAN and bx-proven PyVAN groups, respectively. At the last follow-up, eGFR did not differ between the no, low, and high viremia compared to baseline and to each other but was statistically lower in the presumptive and bx-proven PyVAN (38 +/- 15 and 17 +/- 7 mL/min/1.73 m(2)) either compared to baseline or to the other groups. Conclusions This study shows that low and high levels of BK viremia do not lead to GFR changes although very high viremia levels, compatible with presumptive or bx-proven PyVAN, even if cleared thereafter, lead to allograft damage and decreased GFR.
dc.language.iso eng
dc.publisher WILEY
dc.relation.ispartof Transplant Infectious Disease
dc.rights restrictedAccess
dc.subject allograft kidney function; kidney transplantation; poliomavirus; polymerase chain reaction; polyomavirus-associated nephropathy
dc.subject.other delayed graft function; bk polyomavirus; transplant recipients; renal-transplantation; virus nephropathy; native kidneys; replication; impact; classification; cyclosporine
dc.title Effect of polyoma viremia on 3-year allograft kidney function
dc.type article
dc.rights.holder Copyright WILEY
dc.description.group LIM/47
dc.description.group LIM/52
dc.identifier.doi 10.1111/tid.13056
dc.identifier.pmid 30712328
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author DAVID-NETO, Elias:HC:ICHC
hcfmusp.author AGENA, Fabiana:HC:ICHC
hcfmusp.author DAVID, Daisa Silva Ribeiro:HC:ICHC
hcfmusp.author PAULA, Flavio Jota de:HC:ICHC
hcfmusp.author PIERROTTI, Ligia Camera:HC:ICHC
hcfmusp.author FINK, Maria Cristina Domingues:IMT:SCVIRO-83
hcfmusp.author AZEVEDO, Luiz Sergio Fonseca de:HC:ICHC
hcfmusp.origem.id WOS:000466418200014
hcfmusp.origem.id 2-s2.0-85062544701
hcfmusp.publisher.city HOBOKEN
hcfmusp.publisher.country USA
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dc.description.index MEDLINE
dc.identifier.eissn 1399-3062
hcfmusp.citation.scopus 0
hcfmusp.citation.wos 0

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