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NDT Advance Access originally published online on September 23, 2006
Nephrology Dialysis Transplantation 2006 21(12):3364-3367; doi:10.1093/ndt/gfl404
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Current recommendations for diagnosis and management of polyoma BK virus nephropathy in renal transplant recipients

Katrien Blanckaert and An S. De Vriese

Renal Unit, Department of Internal Medicine, AZ Sint-Jan AV, Brugge, Belgium

Correspondence and offprint requests to: An S. De Vriese, Renal Unit, Department of Internal Medicine, AZ Sint-Jan AV, Ruddershove, 10, B-8000 Brugge, Belgium. Email: an.devriese@azbrugge.be

Keywords: nephropathy; polyoma BK virus; transplantation

The first 150 words of the full text of this article appear below.



   Introduction
 
Polyoma BK virus (BKV) is a ubiquitous DNA virus from the papova virus family [1]. Approximately 60–90% of the adult population worldwide is seropositive for BKV. Primary infection is usually asymptomatic, but the virus establishes latency within the genitourinary tract [1–3]. Reactivation may occur in conditions associated with impaired immunity and is common in renal transplant recipients (10–68%) [1]. Only 1–10% of patients progress from reactivated infection to histologically manifest polyoma BKV nephropathy (BKVN) [1,2,4]. Up to 80% of the patients with BKVN were reported to lose their graft, but early reduction of immunosuppression has been associated with improved prognosis [2,4,5]. We will discuss the available diagnostic tools to identify BKVN and the current practices of adjusting the immunosuppressive regimen. In addition, we review the available evidence supporting the use of cidofovir . . . [Full Text of this Article]



   Diagnostic evaluation
 


   Treatment of BKVN
 
Reduction of immunosuppression
Switch to leflunomide
Antiviral agents: cidofovir


   BKVN and acute rejection
 


   Intravenous immunoglobulins
 


   Pre-emptive treatment of BKV replication
 


   Recommendations
 

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