Nephrotoxicity of calcineurin inhibitors as a risk factor for BK polyomavirus replication after kidney transplantation
Autor: | Tomáš Tichý, Josef Zadražil, Jana Bednaříková, Jiří Orság, Karel Krejčí, Kamil Žamboch, Margita Bartková |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent Biopsy medicine.medical_treatment Calcineurin Inhibitors Viremia Kidney Virus Replication Gastroenterology Nephropathy Nephrotoxicity Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Virology Internal medicine medicine Humans Prospective Studies 030212 general & internal medicine Kidney transplantation Aged Immunosuppression Therapy Polyomavirus Infections medicine.diagnostic_test business.industry Incidence virus diseases Immunosuppression Middle Aged medicine.disease Kidney Transplantation Transplant Recipients Calcineurin Transplantation Tumor Virus Infections Infectious Diseases BK Virus Female Kidney Diseases 030211 gastroenterology & hepatology business |
Zdroj: | Journal of Medical Virology. 93:3871-3879 |
ISSN: | 1096-9071 0146-6615 |
Popis: | BK polyomavirus-associated nephropathy (PyVAN) is responsible for a significant percentage of transplanted kidneys prematurely terminating their function. Its occurrence is closely related to the intensity of immunosuppressive therapy. In a group of 161 newly transplanted patients, we prospectively evaluated 457 protocol renal biopsies performed within the first year after transplantation. Using the calcineurin inhibitors (CI) nephrotoxicity score, the incidence of nephrotoxicity was monitored as a manifestation of excessive immunosuppression. Findings were correlated with clinical evidence of active BK polyomavirus (BKPyV) replication and PyVAN. Compared to the normal histology, nephrotoxicity was associated with more frequent BKPyV viremia and viruria (p = .01 and p < .01, respectively) and more common occurrence of PyVAN. The persistence of toxicity in the subsequent biopsy proved to be a negative risk factor of viremia and viruria (p = .03 and p < .01, respectively), independently of the initial BKPyV status. Toxicity could also be used as a predictor of viremia and viruria (p = .04 and p < .01, respectively) even in the absence of viral replication at the time of initial biopsy. The early histological manifestation of CI nephrotoxicity was associated with significant BKPyV reactivation in the risky first posttransplant year. |
Databáze: | OpenAIRE |
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