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BK nephropathy in the native kidneys of patients with organ transplants: Clinical spectrum of BK infection

World Journal of Transplantation 2016年第3期6卷 472-504页

作者： Darlene Vigil Nikifor K Konstantinov marc Barry antonia m harford Karen S Servilla Young Ho Kim Yijuan Sun Kavitha Ganta Antonios H Tzamaloukas Nephrology Section Medicine Service Raymond G. Murphy VA Medical Center and Department of Medicine University of New Mexico School of Medicine Department of medicine University of Minnesota School of Medicine Department of Pathology University of New Mexico School of Medicine Division of Nephrology Department of Medicine University of New Mexico School of Medicine Division of Nephrology University of North Carolina School of Medicine

Nephropathy secondary to BK virus, a member of the Papoviridae family of viruses, has been recognized for some time as an important cause of allograft dysfunction in renal transplant recipients. In recent times, BK nephropathy(BKN) of the native kidneys has being increasingly recognized as a cause of chronic kidney disease in patients with solid organ transplants, bone marrow transplants and in patients with other clinical entities associated with immunosuppression. In such patients renal dysfunction is often attributed to other factors including nephrotoxicity of medications used to prevent rejection of the transplanted organs. Renal biopsy is required for the diagnosis of BKN. Quantitation of the BK viral load in blood and urine are surrogate diagnostic methods. The treatment of BKN is based on reduction of the immunosuppressive medications. Several compounds have shown antiviral activity, but have not consistently shown to have beneficial effects in BKN. In addition to BKN, BK viral infection can cause severe urinary bladder cystitis, ureteritis and urinary tract obstruction as well as manifestations in other organ systems including the central nervous system, the respiratory system, the gastrointestinal system and the hematopoietic system. BK viral infection has also been implicated in tumorigenesis. The spectrum of clinical manifestations from BK infection and infection from other members of the Papoviridae family is widening. Prevention and treatment of BK infection and infections from other Papovaviruses are subjects of intense research.

关键词： BK viral infection BK nephropathy Cardiac transplant Bone marrow transplant Liver transplant Pancreatic transplant Lung transplant

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