Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Mar;24(3):1024-33.
doi: 10.1093/ndt/gfn671. Epub 2008 Dec 10.

Risk factors for polyoma virus nephropathy

Olivier Prince  1 , Spasenija Savic, Michael Dickenmann, Jürg Steiger, Lukas Bubendorf, Michael J Mihatsch
Affiliations

Risk factors for polyoma virus nephropathy

Olivier Prince et al. Nephrol Dial Transplant. 2009 Mar.

Abstract

Background: Polyoma virus-associated nephropathy (PVN) is a common cause of renal transplant failure. The risk factors for the development of PVN have not yet been studied in large cohorts of patients for periods of 20 years.

Methods: We collected clinical, renal biopsy and urinary cytology data from all patients with renal transplantations performed at the University Hospital of Basel from 1985 to 2005. All patients with a renal biopsy and urine cytology were included (n = 880). Renal transplants were divided into three groups, according to evidence of polyoma virus (PV) infection (decoy cells in the urine) and biopsy-proven PVN: Renal transplants without evidence of a PV infection (n = 751). Renal transplants with PV reactivation, e.g. decoy cell (DC) found by urinary cytology, but without PVN (n = 90). Renal transplants with PVN (n = 39).

Results: The prevalence of biopsy-proven PVN in this cohort of patients was 3.3%. Immunosuppression with mycophenolate and/or tacrolimus, ATGAM, male gender of the recipient and a higher number of transplant rejection episodes were factors significantly associated with PVN development.

Conclusions: The most important risk factors for the development of PVN are acute rejection and ATGAM used as induction therapy as well as tacrolimus and mycophenolate as maintenance therapy. Therefore, we conclude that patients with tacrolimus and mycophenolate maintenance therapy should be carefully monitored for the development of PVN.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Biopsies with/without PVN in relation to therapy in a 20 year period in Basel CyA = cyclosporin-A, MMF = mycophenolate mofetil, PVN = polyomavirus-associated nephropathy.
See this image and copyright information in PMC

References

    1. Gardner SD, Field AM, Coleman DV, et al. New human papovavirus (B.K.) isolated from urine after renal transplantation. Lancet. 1971;1:1253–1257. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dop... . - PubMed
    1. Mackenzie EF, Poulding JM, Harrison PR, et al. Human polyoma virus (HPV)—a significant pathogen in renal transplantation. Proc Eur Dial Transplant Assoc. 1978;15:352–360. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&a&d... . - PubMed
    1. Rosen S, Harmon W, Krensky AM, et al. Tubulo-interstitial nephritis associated with polyomavirus (BK type) infection. N Engl J Med. 1983;308:1192–1196. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dop... . - PubMed
    1. Arthur RR, Shah KV, Baust SJ, et al. Association of BK viruria with hemorrhagic cystitis in recipients of bone marrow transplants. N Engl J Med. 1986;315:230–234. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dop... . - PubMed
    1. Chapman C, Flower AJ, Durrant ST. The use of vidarabine in the treatment of human polyomavirus associated acute haemorrhagic cystitis. Bone Marrow Transplant. 1991;7:481–483. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dop... . - PubMed