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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Main Authors: 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
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Nefrologia 2021
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000300434
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spelling 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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country Brasil
countrycode BR
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libraryname SciELO
language English
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author 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
spellingShingle 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
author_facet 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
author_sort 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
title_fullStr BK virus nephropathy in a heart transplant recipient
title_full_unstemmed BK virus nephropathy in a heart transplant recipient
title_sort bk virus nephropathy in a heart transplant recipient
description 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.
publisher Sociedade Brasileira de Nefrologia
publishDate 2021
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000300434
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