Analysis of risk factors influencing the BK polyomavirus replication in patients with ESRD waiting for kidney transplantation. (December 2020) - Pourkazemi, Aydin
Abstract: Background: Since the pre-transplant status affects the renal transplantation success and ultimately the survival rate, identifying the probable risk factors that increase the chance of BK virus replication in end-stage renal disease patients can be included in proposing proper surveillance guidelines during pre and post-transplantation. Methods: A descriptive cross-sectional study was performed by collecting plasma samples from 192 ESRD patients undergoing hemodialysis for at least 3 months. Quantitative Real-time PCR assay was used to detect and measure the BK viral load. Demographic and clinical characteristics of the patients who had BK viremia were documented. Results: 14 (7.3%) out of our 192 participants had BK virus viremia (95%CI 4.2%–11.6%). Demographic characteristics including etiology of ESRD and underlying diseases, mean duration and frequency of dialysis, co-infection with HBV and HCV did not affect the virus replication, since the difference between patients with BK virus viremia and BK virus negative individuals was not statistically significant. However, the statistical significance of the mean age of men with BKV and without BK virus viremia was found (OR: 3.42, P = 0.02 95%CI 0.86–13.61). Also, multiple regression analyses of some other parameters revealed that old age, high body mass index and male gender can be predictive factors of BK virus viremia in ESRD patients. Conclusion: Based on our findings, elderly male had higher chance of being exposed to BK virus viremia. Some other demographic characteristics such as a high BMI, old age and gender (male) can increase the risk of BK viremia in patients with ESRD prior to kidney transplantation. Highlights: Pre-transplant viral status could be considered as a risk factor for post-transplant BK virus replication that could lead to acute graft failure. Determination of probable predictive factors leading to BK virus viremia in end-stage renal disease patients can be included in designing proper surveillance guidelines during pre and post-transplantation. The prevalence of BK viremia among 192 patients with ESRD on hemodialysis was 7.3%. Higher mean age among men could be considered as a significant risk factor for BK viremia in ESRD patients. Parameters including: a high body mass index (BMI), older age and male gender can increase the rate of BK virus viremia in ESRD patients.