BK virus‐associated nephropathy: neutrophil gelatinase‐associated lipocalin as a new diagnostic tool?. (13th February 2013)

• Record Type: Journal Article
• Authors: Rau, Simon; Schönermarck, Ulf; Jäger, Gundula; Stangl, Manfred; Guba, Markus; Meiser, Bruno; Fischereder, Michael; Habicht, Antje
• Is Part Of: Clinical transplantation. Volume 27:Number 2(2013:Mar./Apr.)
• Page Start: E184
• Page End: E191
• Publication Date: 2013-02-13
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12081
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" xml:lang="en" id="ctr12081-abs-0001"> <title>Abstract</title> <sec id="ctr12081-sec-0001" sec-type="section"> <title>Introduction</title> <p>BK nephropathy has emerged as an important cause for allograft failure in renal transplant patients. The kidney tubules are the main target of BK virus infiltration. Neutrophil gelatinase‐associated lipocalin (NGAL) has been proven to be a powerful biomarker for tubular damage. Therefore, we investigated the suitability of plasma NGAL as new diagnostic tool in patients with BK infection.</p> </sec> <sec id="ctr12081-sec-0002" sec-type="section"> <title>Material and methods</title> <p>We retrospectively analyzed 240 renal transplant recipients. Systematic BKV screening by plasma PCR was performed one month after transplantation and every three month thereafter for two yr. Plasma NGAL concentration was investigated using a commercial ELISA. Medical records and electronic databases were reviewed for clinical parameters.</p> </sec> <sec id="ctr12081-sec-0003" sec-type="section"> <title>Results</title> <p>BK viremia (BKV+) was diagnosed in 5.0% (12/240) and BK nephropathy in 3.3% (8/240) of our patients. BKV+ patients received more induction therapy (p = 0.03) and experienced a higher rate of biopsy‐proven rejections compared to 13 control patients with similar graft function but negative BKV PCR. Contrary to our hypothesis, there was no difference in plasma NGAL expression between both groups (128.6 vs. 172.2 ng/mL; p = 0.68).</p> </sec> <sec id="ctr12081-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Intensified immunosuppressive therapy is associated with an increased risk for BK nephropathy. Plasma NGAL is neither suitable for diagnosing BK nephropathy nor helpful in predicting the individual course of patients with BKV infection.</p> </sec> </abstract>