Kidney transplant recipients with polycystic kidney disease have a lower risk of post‐transplant BK infection than those with end‐stage renal disease due to other causes. Issue 6 (30th August 2018)

• Record Type: Journal Article
• Authors: Plafkin, Callie; Singh, Tripti; Astor, Brad C.; Parajuli, Sandesh; Bhutani, Gauri; Safdar, Nasia; Panzer, Sarah E.
• Is Part Of: Transplant infectious disease. Volume 20:Issue 6(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-08-30
• Subjects: BK virus -- kidney transplant -- polycystic kidney disease; Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12974
• Languages: English
• ISSNs: 1398-2273

Abstract

Abstract: Background: Polyomavirus‐associated nephropathy is associated with high risk of kidney allograft loss. Whether the cause of native end‐stage renal disease influences the risk of BK infection is unclear. Methods: A retrospective, single‐center study of 2741 adult kidney transplant recipients between 1994 and 2014 was performed. Recipients had end‐stage renal disease due to polycystic kidney disease (PKD, n = 549), diabetes mellitus (DM, n = 947), hypertension (HTN, n = 442), or glomerulonephritis (GN, n = 803). Results: A total of 327 recipients (12%) developed post‐transplant BK viremia over a median follow‐up time of 5 years. The incidence rate of BK viremia was lowest in patients with PKD (1.46 per 100 person‐years) compared to other causes of ESRD (DM = 2.06, HTN = 2.65, and GN = 2.01 per 100 person‐years). A diagnosis of PKD was associated with a lower risk of post‐transplant BK viremia (adjusted HR (95% CI) = 0.67 (0.48‐0.95), P = 0.02). BK nephropathy was significantly less common in patients with PKD (0.21 per 100 person‐years) compared to those with HTN (0.80 per 100 person‐years, P ≤ 0.001). Among patients with PKD, the risk of BK viremia was lower in patients with nephrectomy, compared to those without nephrectomy (adjusted HR (95% CI) = 0.42 (0.19‐0.92), P < 0.05). Conclusion: ESRD due to PKD is associated with a lower risk of post‐transplant BK infection. The renal tubular epithelial cells in PKD are unique; they are in a proliferative but non‐differentiated state. Whether this characteristic of renal tubular epithelial cells alters the BK viral reservoir or replication in PKD patients warrants further study.