Early Detection Strategy of BK Polyomavirus Nephropathy in Patients undergoing Renal Transplant: A Single-Center Retrospective Study

Abstract

Introduction: BK polyoma virus nephropathy represents one of the non-immunological causes of renal graft loss with a cumulative incidence between 5 and 10 percent, and a graft loss rate on BK virus nephropathy patients that ranges from 30 to 90 percent depending on the nephropathy status at the time of diagnosis (1). Objective: To determine the outcomes regarding the kidney graft survival and kidney function of an early detection strategy for BK Polyomavirus nephropathy which is drawn upon urinary cytology in order to look for Decoy cells. Methodology: Descriptive, retrospective study type. Adult renal transplant recipients/patients from the Interdisciplinary Renal Transplant program of the Colombia University Clinic were included in a time period from 2012 to 2018, in whom monthly post-transplant monitoring with positive urinary cytology was performed. Results: 303 patients were transplanted in the program, 107 patients with positive urinary cytology were included, wherein, men predominated with 72% and 45 years old being the average age (IQR: 18–72). The cumulative incidence of polyomavirus nephropathy, under this early detection strategy, was 9.2%, thus preserving the graft survival at 24 months in a 100% of the patients with the management strategies employed. Conclusions: This early detection and monitoring study utilizing post-transplant urinary cytology proved to be useful for the early diagnosis of BK Polyomavirus nephropathy with a favorable impact on the graft livelihood.