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Paper Information

Journal:   IRANIAN JOURNAL OF KIDNEY DISEASES (IJKD)   DECEMBER 2009 , Volume 3 , Number SUPPLEMENT 1 (12TH INTERNATIONAL CONGRESS OF NEPHROLOGY, DIALYSIS, AND TRANSPLANTATION); Page(s) 37 To 37.
 
Paper: 

CHARACTERISTICS THAT BK VIREMIA MAY CORRELATE IN OUR RENAL TRANSPLANT RECIPIENTS (ORAL PRESENTATIONS: O405)

 
 
Author(s):  AMIRKHANLOU S., AHMADPOUR P., POURREZA GHOLI F., SAMADIAN F., PARVIN M., FIROUZAN A., ALIPOUR ABEDI B., EYN ELAHI B., NAFAR M.
 
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Abstract: 

Introduction. Over the last 10 years, Bk virus has been increasingly recognized as an important cause of renal allograft dysfunction. This probably reflects more recognition and reporting of the disease, but also the effect of more powerful maintenance immunosuppressive regimens incorporating MMF and tacrolimus. The specific role of different immunosuppressive agents and other characteristics as risk factors for BKV nephropathy has not been well studied.
Methods. In a cross-sectional study, we reviewed all patients who underwent kidney transplantation in our center between September 2008 and September 2009, and the correlation of BK viremia with CMV antigenemia, corticosteroid pulse therapy, ATG, cyclosporine blood level, gender, and blood group was studied.
Results. A total of 121 out of 205 patients were checked for BK viremia by qualitative plasma PCR. Of these, 75 were male patients, and 11 were BK viremic (10.7% of the recipients). The mean Cr in BK viremia positive group, 1 month after treansplantation, was 1.2 mg/ dl, in contrast to negative group that was 1.4 mg/dl. Between 3 and 6 month after transplantation, the mean Cr in positive and negative groups was 1.8 mg/dl and 1.35 mg/dl, respectively. The mean cyclosporine starting dose in BK viremic group was 6.59 mg/kg and 6.75 mg/ kg in negative group without a statistically significant difference. Mean of trough cyclosporine blood trough levels in months 1, 2, and 3 in BK viremic patients were 281, 279, and 233 ng/ml that when comparable to BK negative patients (310, 321, and 233 ng/ml; P > 0.05). Same results were drawn when C2 cyclosporin blood levels was considered (P > 0.05). Ten out of 11 BK viremic patients were male but in BK negative group, 65 of 110 were male. (Odds ratio = 6.9). Frequency of BK viremia was more common in males (P = 0.038). CMV antigenemia test was positive in 5/11 BK viremic patients but in negative group, was positive in 18/110 patients (odds ratio = 4.25).This means positive CMV antigenemia was more frequent in BK viremic group (P = 0.019). Regarding corticosteroid pulse therapy, 6/11 BK viremic patients were retreated by corticosteroid pulse therapy versus 30/110 patients in BK negative group. The odds ratio for corticosteroid pulse therapy was 3.2. Frequency of BK viremia was more in those patients in whom, immunosuppressive treatment was intensified by steroid pulses (P = 0.05). Correlation between BK viremia and blood group and induction with ATG were not statistically significant. Conclusions. The results of this study have shown that BK viremia is correlated with male gender, CMV antigenemia, and corticosteroid pulse therapy, but not with ATG, blood group, and cyclosporine blood level.

 
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