Ureteral stent placement and BK viremia in kidney transplant recipients

被引:28
作者
Kayler, L. [1 ]
Zendejas, I. [2 ]
Schain, D. [3 ]
Magliocca, J. [4 ]
机构
[1] Montefiore Med Ctr, Dept Surg, Bronx, NY 10467 USA
[2] Univ Florida, Dept Surg, Gainesville, FL USA
[3] Univ Florida, Dept Med, Gainesville, FL USA
[4] Emory Univ, Dept Surg, Atlanta, GA 30322 USA
关键词
ureteral stent; kidney transplant; BK virus; BK nephropathy; BK viremia; POLYOMAVIRUS NEPHROPATHY; REPLICATION; INFECTION; IMPACT; VIRUS;
D O I
10.1111/tid.12051
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Introduction BK virus (BKV) infection is an important cause of kidney transplant dysfunction. A possible association of double-J ureteral stent placement and BK viremia has been suggested in previous studies; however, risk factors for BK are incompletely understood. We aimed to determine if stent placement is an independent risk factor for BK viremia. Methods Data were collected on consecutive kidney-only transplant recipients between December 1, 2006 and June 30, 2010. All patients had at least 12months of follow-up. Results Of 600 consecutive kidney transplants, BK viremia within the first post-transplant year was detected in 93 patients (15.5%); in 70 of these cases, the peak BKV polymerase chain reaction was 10,000 copies/mL. By multivariate analysis, significant risk factors for BK viremia were recipient age (P=0.02) and stent placement (P=0.03). Stents were placed in 49.2% and removed at a median of 46days (range: 11284) post transplantation; removals occurred within 030, 3060, 6090, 90120, 120150, and >150days post transplantation in 18.4%, 67.2%, 10.5%, 2.4%, 1.0%, and 0.3% of cases, respectively. No association was found of BK viremia with stent duration >46days (P=0.70) or by the 6-level groupings (P=0.92). Conclusions Although we observed a significant association of BK viremia with stent placement, no dose-dependent effect was seen.
引用
收藏
页码:202 / 207
页数:6
相关论文
共 12 条
  • [1] POLYOMAVIRUS REPLICATES IN DIFFERENTIATING BUT NOT IN PROLIFERATING TUBULES OF ADULT-MOUSE POLYCYSTIC KIDNEYS
    ATENCIO, IA
    VILLARREAL, LP
    [J]. VIROLOGY, 1994, 201 (01) : 26 - 35
  • [2] ADULT-MOUSE KIDNEYS BECOME PERMISSIVE TO ACUTE POLYOMAVIRUS INFECTION AND REACTIVATE PERSISTENT INFECTIONS IN RESPONSE TO CELLULAR-DAMAGE AND REGENERATION
    ATENCIO, IA
    SHADAN, FF
    ZHOU, XJ
    VAZIRI, ND
    VILLARREAL, LP
    [J]. JOURNAL OF VIROLOGY, 1993, 67 (03) : 1424 - 1432
  • [3] Incidence of BK with tacrolimus versus cyclosporine and impact of preemptive immunosuppression reduction
    Brennan, DC
    Agha, I
    Bohl, DL
    Schnitzler, MA
    Hardinger, HL
    Lockwood, M
    Torrence, S
    Schuessler, R
    Roby, T
    Gaudreault-Keener, M
    Storch, GA
    [J]. AMERICAN JOURNAL OF TRANSPLANTATION, 2005, 5 (03) : 582 - 594
  • [4] Polyomavirus BK replication dynamics In vivo and In silico to predict cytopathology and viral clearance in kidney transplants
    Funk, G. A.
    Gosert, R.
    Comoli, P.
    Ginevri, F.
    Hirsch, H. H.
    [J]. AMERICAN JOURNAL OF TRANSPLANTATION, 2008, 8 (11) : 2368 - 2377
  • [5] BK virus: Opportunity makes a pathogen
    Hirsch, HH
    [J]. CLINICAL INFECTIOUS DISEASES, 2005, 41 (03) : 354 - 360
  • [6] Polyomavirus-associated nephropathy in renal transplantation: Interdisciplinary analyses and recommendations
    Hirsch, HH
    Brennan, DC
    Drachenberg, CB
    Ginevri, F
    Gordon, J
    Limaye, AP
    Mihatsch, MJ
    Nickeleit, V
    Ramos, E
    Randhawa, P
    Shapiro, R
    Steiger, J
    Suthanthiran, M
    Trofe, J
    [J]. TRANSPLANTATION, 2005, 79 (10) : 1277 - 1286
  • [7] Prospective study of polyomavirus type BK replication and nephropathy in renal-transplant recipients
    Hirsch, HH
    Knowles, W
    Dickenmann, M
    Passweg, J
    Klimkait, T
    Mihatsch, MJ
    Steiger, J
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (07) : 488 - 496
  • [8] Ureteral necrosis after kidney transplantation: Risk factors and impact on graft and patient survival
    Karam, G
    Maillet, F
    Parant, S
    Soulillou, JP
    Giral-Classe, M
    [J]. TRANSPLANTATION, 2004, 78 (05) : 725 - 729
  • [9] VESICOURETERAL REFLUX IN PATIENTS WITH DOUBLE PIGTAIL STENTS
    MOSLI, HA
    FARSI, HMA
    ALZIMAITY, MF
    SALEH, TR
    ALZAMZAMI, MM
    [J]. JOURNAL OF UROLOGY, 1991, 146 (04) : 966 - 969
  • [10] Polyomavirus nephropathy: morphology, pathophysiology, and clinical management
    Nickeleit, V
    Singh, HK
    Mihatsch, MJ
    [J]. CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION, 2003, 12 (06) : 599 - 605