BK virus nephropathy in a heart transplant recipient
Abstract BK virus nephropathy in kidney transplantation is widely recognized as an important cause of graft dysfunction and loss. In the case of transplants of organs other than kidney, BK virus nephropathy in native kidneys has been recognized as a cause of chronic kidney disease, which is related with immunosuppression; however, the diagnosis is usually late because the renal dysfunction is attributed to other causes, such as toxicity by anticalcineurinic drugs, interstitial nephritis due to medications, hemodynamic changes, diabetes, hypertension, etc. We report a case of BK virus nephropathy in a patient who underwent heart transplantation due to peripartum cardiomyopathy. The kidney biopsy reported active chronic tubulointerstitial nephritis associated with late stage polyomavirus nephritis and the blood viral load for BK virus was positive (logarithm 4.5). The immunosuppressive treatment was reduced, and after two years of follow-up, the patient had stable renal function with a serum creatinine of 2.5 mg/dL (GFR of 23.4 mL/min/1.73m2). We recommend that the BK virus be considered as a cause of renal dysfunction in heart transplant recipients, with the aim of detecting its replication in time to reduce immunosuppressive therapy before irreversible compromise of renal function may manifest.
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Sociedade Brasileira de Nefrologia
2021
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oai:scielo:S0101-280020210003004342021-11-05BK virus nephropathy in a heart transplant recipientNieto-Ríos,John FredyBenavides-Henao,Diego ArmandoAristizabal-Alzate,ArbeyMorales-Contreras,CarolChacón-Jaimes,Diana CarolinaZuluaga-Valencia,GustavoSerna-Higuita,Lina María Polyomavirus BK virus BK Virus Nephropathy Organ Transplantation Heart Transplantation Immunosuppression. Abstract BK virus nephropathy in kidney transplantation is widely recognized as an important cause of graft dysfunction and loss. In the case of transplants of organs other than kidney, BK virus nephropathy in native kidneys has been recognized as a cause of chronic kidney disease, which is related with immunosuppression; however, the diagnosis is usually late because the renal dysfunction is attributed to other causes, such as toxicity by anticalcineurinic drugs, interstitial nephritis due to medications, hemodynamic changes, diabetes, hypertension, etc. We report a case of BK virus nephropathy in a patient who underwent heart transplantation due to peripartum cardiomyopathy. The kidney biopsy reported active chronic tubulointerstitial nephritis associated with late stage polyomavirus nephritis and the blood viral load for BK virus was positive (logarithm 4.5). The immunosuppressive treatment was reduced, and after two years of follow-up, the patient had stable renal function with a serum creatinine of 2.5 mg/dL (GFR of 23.4 mL/min/1.73m2). We recommend that the BK virus be considered as a cause of renal dysfunction in heart transplant recipients, with the aim of detecting its replication in time to reduce immunosuppressive therapy before irreversible compromise of renal function may manifest.info:eu-repo/semantics/openAccessSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology v.43 n.3 20212021-09-01info:eu-repo/semantics/reporttext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000300434en10.1590/2175-8239-jbn-2020-0049 |
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Nieto-Ríos,John Fredy Benavides-Henao,Diego Armando Aristizabal-Alzate,Arbey Morales-Contreras,Carol Chacón-Jaimes,Diana Carolina Zuluaga-Valencia,Gustavo Serna-Higuita,Lina María |
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Nieto-Ríos,John Fredy Benavides-Henao,Diego Armando Aristizabal-Alzate,Arbey Morales-Contreras,Carol Chacón-Jaimes,Diana Carolina Zuluaga-Valencia,Gustavo Serna-Higuita,Lina María BK virus nephropathy in a heart transplant recipient |
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Nieto-Ríos,John Fredy Benavides-Henao,Diego Armando Aristizabal-Alzate,Arbey Morales-Contreras,Carol Chacón-Jaimes,Diana Carolina Zuluaga-Valencia,Gustavo Serna-Higuita,Lina María |
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Nieto-Ríos,John Fredy |
title |
BK virus nephropathy in a heart transplant recipient |
title_short |
BK virus nephropathy in a heart transplant recipient |
title_full |
BK virus nephropathy in a heart transplant recipient |
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BK virus nephropathy in a heart transplant recipient |
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BK virus nephropathy in a heart transplant recipient |
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bk virus nephropathy in a heart transplant recipient |
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Abstract BK virus nephropathy in kidney transplantation is widely recognized as an important cause of graft dysfunction and loss. In the case of transplants of organs other than kidney, BK virus nephropathy in native kidneys has been recognized as a cause of chronic kidney disease, which is related with immunosuppression; however, the diagnosis is usually late because the renal dysfunction is attributed to other causes, such as toxicity by anticalcineurinic drugs, interstitial nephritis due to medications, hemodynamic changes, diabetes, hypertension, etc. We report a case of BK virus nephropathy in a patient who underwent heart transplantation due to peripartum cardiomyopathy. The kidney biopsy reported active chronic tubulointerstitial nephritis associated with late stage polyomavirus nephritis and the blood viral load for BK virus was positive (logarithm 4.5). The immunosuppressive treatment was reduced, and after two years of follow-up, the patient had stable renal function with a serum creatinine of 2.5 mg/dL (GFR of 23.4 mL/min/1.73m2). We recommend that the BK virus be considered as a cause of renal dysfunction in heart transplant recipients, with the aim of detecting its replication in time to reduce immunosuppressive therapy before irreversible compromise of renal function may manifest. |
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Sociedade Brasileira de Nefrologia |
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2021 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000300434 |
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