Risk factors and outcome of BK polyomavirus infection in pediatric kidney transplantation.

Autor: Lin F; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China., Zhang Z; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China., Wang C; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China., Liu F; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China., Chen R; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China., Chen J; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China., Fang X; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China., Sun Y; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China.; Department of Urology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China., Zhai Y; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China. marinezyh@163.com.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China. marinezyh@163.com., Xu H; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China. hxu@shmu.edu.cn.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China. hxu@shmu.edu.cn.; National Key Laboratory of Kidney Diseases, Shanghai, China. hxu@shmu.edu.cn., Shen Q; Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China. shenqian@shmu.edu.cn.; Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai, China. shenqian@shmu.edu.cn.; National Key Laboratory of Kidney Diseases, Shanghai, China. shenqian@shmu.edu.cn.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Dec; Vol. 39 (12), pp. 3559-3567. Date of Electronic Publication: 2024 Aug 01.
DOI: 10.1007/s00467-024-06473-8
Abstrakt: Background: BK polyomavirus (BKV) infection is a critical complication hindering graft survival after kidney transplantation. We aimed to investigate the risk factors and outcome of BKV infection in pediatric kidney transplantation.
Methods: The clinical and follow-up data of pediatric kidney transplant recipients at the Children's Hospital of Fudan University from Jan 2015 to June 2023 were retrospectively analyzed.
Results: A total of 217 patients were included in the study with mean follow-up time of 24.3 ± 19.9 months. The mean age at transplantation was 9.7 ± 4.2 years. The patient survival rate and graft survival rate were 98.2% and 96.8%, respectively. Twenty-nine patients (13.4%) developed BKV infection, which was detected at 5.8 ± 3.2 months after transplantation. Among these 29 patients with BKV infection, 8 patients (3.6%) developed BKV nephropathy (BKVN), which was diagnosed at 8.3 ± 2.9 months after transplantation, and 2 patients developed graft failure eventually. Compared with the non-BKV infection group (eGFR 76.7 ± 26.1 mL/min/1.73 m 2 ) and BKV infection without BKVN group (eGFR 85.2 ± 23.8 mL/min/1.73 m 2 ), BKVN group had lowest eGFR during follow-up (33.5 ± 11.0 ml/min/1.73 m 2 , P < 0.001). Younger age at transplant (OR 0.850, 95%CI 0.762-0.948, P = 0.005), CAKUT disease of primary etiology (OR 2.890, 95%CI 1.200-6.961, P = 0.018), and CMV negative recipient serostatus before transplantation (OR 3.698, 95%CI 1.583-8.640, P = 0.003) were independent risk factors for BKV infection.
Conclusions: Incidence of BKV infection is quite high within 12 months after pediatric kidney transplantation and children with BKVN have poor graft function. Younger age at transplant, CAKUT disease, and CMV negative recipient serostatus before transplantation increase the risk of BKV infection after kidney transplantation.
(© 2024. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
Databáze: MEDLINE
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