Outcomes of Living Kidney Donor Candidates and Living Kidney Recipient Candidates with JC Polyomavirus and BK Polyomavirus Viruria

Sara Querido,Teresa Adragão,Maria Ana Pessanha,Carolina Ormonde,Perpétua Gomes,André Weigert,Inês Costa,Franca Anglani

doi:10.1155/2021/8010144

Sara Querido, Teresa Adragão + Show 6 more

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https://doi.org/10.1155/2021/8010144

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Abstract

Introduction Recent data have emerged about a protective association between JCV viruria and chronic kidney disease (CKD). Material and Methods. Single-center retrospective cohort study; 230 living kidney donors (LKD) candidates and 59 potential living kidney receptors (LKR) were enrolled. Plasma and urinary JCV and BKV viral loads were measured in all LKD candidates and in nonanuric LKR candidates. Twenty-six living kidney transplant surgeries were performed. LKR were followed in order to evaluate BKV and JCV viremia and urinary viral shedding after KT. Results In LKD candidates, JCV viruria was negatively associated with proteinuria of >200 mg/24 hours (JC viruric LKD: 12.5% vs JCV nonviruric LKD: 26.7%, p=0.021, OR:0.393; 95% CI: 0.181–0.854). In a multivariate analysis, LKD candidates with JCV viruria had a lower risk of proteinuria of >200 mg/24 hours (p=0.009, OR: 0.342, 95% CI: 0.153–0.764), in a model adjusted for age, gender, presence of hypertension, and eGFR <80 mL/min. Prevalence of JCV viruria was higher in LKD candidates when compared with LKR candidates (40.0% vs 1.7%, p < 0.001). Among the 26 LKR, 14 (53.8%) KT patients evolved with JCV viruria; 71.4% received a graft from a JCV viruric donor. Conclusion Our data corroborate the recent findings of an eventual protective association between JCV viruria and kidney disease, and we extrapolated this concept to a South European population.

Highlights

Recent data have emerged about a protective association between JC polyomavirus (JCV) viruria and chronic kidney disease (CKD)
Unilateral nephrectomy inevitably leads to reduced renal mass and function [2], which associates with a rise in blood pressure and increased proteinuria [3, 4]. ese factors are responsible for a high risk of cardiovascular and all-cause mortality in general population and, eventually, in living kidney donors (LKD) [5]. erefore, a careful selection of LKD is crucial, in order to minimize the potential risks associated with living kidney donation [6]
JCV viruria was not associated with an estimated glomerular filtration rare (eGFR) of 200 mg/24 hours (JC viruric LKD: 12.5% vs JCV nonviruric LKD: 26.7%, p 0.021, OR: 0.393; 95% CI: 0.181–0.854)

Summary

Introduction

Recent data have emerged about a protective association between JCV viruria and chronic kidney disease (CKD). Our data corroborate the recent findings of an eventual protective association between JCV viruria and kidney disease, and we extrapolated this concept to a South European population. Ese factors are responsible for a high risk of cardiovascular and all-cause mortality in general population and, eventually, in living kidney donors (LKD) [5]. Many donor baseline characteristics, such as age, predonation estimated glomerular filtration rare (eGFR) and blood pressure, have been included in recent guidelines for the preoperative assessment of LKD [7, 8]; polyomavirus viruria is not routinely measured in either living or cadaveric donors. Patients with chronic kidney disease (CKD) have a significantly reduced urinary shedding rate of JCV, as low as 2.2% [13]

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