López V, Gutiérrez C, Burgos D, González Molina M, Cabello M, Sola E, Garcia I, Siles J, Florez P
Nephrology Department, Hospital Universitario Carlos Haya, Malaga, Spain.
Transplant Proc. 2008 Nov;40(9):2927-9. doi: 10.1016/j.transproceed.2008.08.098.
Nephropathy due to polyomavirus is usually diagnosed by renal biopsy after worsening of renal function. This is normally at an advanced stage of the disease.
To study the early detection of the presence of BK and JC polyomavirus in urine by monthly real-time quantitative polymerase chain reaction (PCR) assay.
The study included 76 kidney transplant recipients from cadaveric donors between August 2005 and July 2006 with a 1-year follow-up.
Viruria was positive in 31 patients (40.7%) and viremia in 7 (9.2%), three of whom (3.9%) developed nephropathy. After reduction of the immunosuppression, the viruria became negative in 32.0% and the viremia in 42.8% of the patients. Renal function (creatinine clearance, aMDRD) at 1 year was 49.2 mL/min/1.73 m(2) in the patients with nephropathy and 64.3 mL/min/1.73 m(2) in the others. One-year patient and graft survival was 96%. No patient lost the graft due to nephropathy.
The detection of BK and JC polyomavirus by protocolized PCR enabled an early diagnosis of nephropathy, preventing graft loss with good renal function at 1 year.
多瘤病毒所致肾病通常在肾功能恶化后通过肾活检确诊，而此时疾病往往已处于晚期。
通过每月一次的实时定量聚合酶链反应（PCR）检测，研究尿液中BK和JC多瘤病毒的早期检测情况。
该研究纳入了2005年8月至2006年7月间76例接受尸体供肾移植的受者，并进行了为期1年的随访。
31例患者（40.7%）病毒尿呈阳性，7例（9.2%）病毒血症呈阳性，其中3例（3.9%）发生了肾病。免疫抑制降低后，32.0%的患者病毒尿转阴，42.8%的患者病毒血症转阴。发生肾病的患者1年时的肾功能（肌酐清除率，aMDRD）为49.2 mL/min/1.73 m²，其他患者为64.3 mL/min/1.73 m²。患者和移植物1年生存率为96%。无患者因肾病而失去移植物。
通过规范化的PCR检测BK和JC多瘤病毒能够早期诊断肾病，在1年时可防止移植物丢失并保持良好的肾功能。
