Document Detail


Sustained BK viruria as an early marker for the development of BKV-associated nephropathy: analysis of 4128 urine and serum samples.
MedLine Citation:
PMID:  19584686     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: BKV reactivation plays the causative role in the development of BKV-associated nephropathy (BKVAN). Because of the lack of effective therapy, early diagnosis of BKV reactivation is paramount for the prevention of BKVAN. Resting in uroepithelial cells, BKV is excreted first in urine before it can be detected in plasma. The present study analyzed predictive value of BK viruria for the development of BK viremia and its possible advantage for the early BKVAN prediction. METHODS: Total of 4128 urine and serum samples obtained from renal transplant patients were analyzed for BKV positivity by real-time polymerase chain reaction in 433 patients in cross-sectional and in 233 patients in longitudinal manner, respectively. The prospective longitudinal analysis included seven measurements during the first posttransplant year. RESULTS: A total of 7% and 19% patients were positive for BKV in serum and urine, respectively. Sustained BK viruria showed sensitivity of 100% and specificity of 94% for BK viremia and was associated with significantly higher level of BK load than the patients with transient viruria (P<0.01). Interestingly, BK viremia was preceded by BK viruria: the peak of viral load and number of positive patients appeared during the third and fifth posttransplant month for urine and serum, respectively. BKVAN diagnosed in 21.4% of patient with persistent BK viruria appeared 5 and 11 weeks after BKV reactivation in serum and urine, respectively, was detected. CONCLUSION: Sustained BK viruria is a reliable marker allowing an early identification of patients at high risk of BKVAN development and therefore assure precocious therapeutic interventions.
Authors:
Nina Babel; Juliane Fendt; Stoyan Karaivanov; Gantuja Bold; Steffen Arnold; Anett Sefrin; Evelyn Lieske; Martin Hoffzimmer; Mikalai Dziubianau; Nicole Bethke; Christian Meisel; Gerald Grütz; Petra Reinke
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transplantation     Volume:  88     ISSN:  1534-6080     ISO Abbreviation:  Transplantation     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-08     Completed Date:  2009-07-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  89-95     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Charité University Medicine Berlin, Campus Virchow Clinic, Berlin, Germany. nina.babel@charite.de
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MeSH Terms
Descriptor/Qualifier:
Adult
BK Virus / genetics,  isolation & purification*
Cross-Sectional Studies
DNA, Viral / blood,  isolation & purification*,  urine
Early Diagnosis
Female
Humans
Kaplan-Meiers Estimate
Kidney Diseases / blood,  diagnosis*,  drug therapy,  urine,  virology
Kidney Transplantation / adverse effects*
Logistic Models
Male
Middle Aged
Polymerase Chain Reaction
Polyomavirus Infections / blood,  diagnosis*,  drug therapy,  urine,  virology
Predictive Value of Tests
Prevalence
Prospective Studies
Reproducibility of Results
Risk Assessment
Sensitivity and Specificity
Time Factors
Viral Load
Viremia / diagnosis
Virus Activation
Chemical
Reg. No./Substance:
0/DNA, Viral

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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