Mitterhofer A P, Umbro I, Pietropaolo V, Meçule A, Russo G E, Tinti F, Fiacco F, Poli L, Bellizzi A, Anzivino E, Ferretti G, Berloco P B, Chiarini F, Taliani G
Department of Clinical Medicine, Nephrology and Dialysis Unit, Sapienza University of Rome, Rome, Italy.
Transplant Proc. 2012 Sep;44(7):1869-72. doi: 10.1016/j.transproceed.2012.06.021.
Patients in end-stage renal disease undergoing renal replacement treatment (ESRD-RRT) are considered immunocompromised. The hemodialysis (HD) or peritoneal dialysis (PD) procedures seem to produce alterations of the immune status. Interest in immunosuppression has increased due to the poliomavirus BK (BKV) infection. Our study evaluated the prevalence of BKV infection in ESRD-RRT patients and viral replication on HD or PD. From 2006 to 2011 we selected 58 patients (34 males) in ESRD-RRT for inclusion in our study. BKV replication was evaluated by qualitative real-time polymerase chain reaction. In ESRD-RRT patients, the prevalence of BKV replication on plasma was 21%. We identified two groups of patients according to the dialysis procedure: 36 patients on HD (HD group) and 22 on PD (PD group). BKV replication in the HD group was 33% (12 of 36) versus 0% (0 of 22) in the PD group. Different age, number of months on RRT, and preserved diuresis was observed in the HD versus PD groups. With our results we can speculate that BKV infection in ESRD-RRT patients is linked to factors involved in the uremia-related immune dysfunction but also to specific mechanisms related to the different RRTs. PD is an option that could be associated with a better transplant outcome for patients undergoing kidney transplantation.
接受肾脏替代治疗的终末期肾病患者（ESRD-RRT）被认为存在免疫功能低下。血液透析（HD）或腹膜透析（PD）程序似乎会导致免疫状态的改变。由于多瘤病毒BK（BKV）感染，人们对免疫抑制的关注度有所增加。我们的研究评估了ESRD-RRT患者中BKV感染的患病率以及HD或PD上的病毒复制情况。从2006年到2011年，我们选择了58例ESRD-RRT患者（34例男性）纳入我们的研究。通过定性实时聚合酶链反应评估BKV复制情况。在ESRD-RRT患者中，血浆中BKV复制的患病率为21%。我们根据透析程序将患者分为两组：36例接受HD治疗的患者（HD组）和22例接受PD治疗的患者（PD组）。HD组中BKV复制率为33%（36例中的12例），而PD组为0%（22例中的0例）。HD组和PD组在年龄、RRT治疗月数和尿量保留方面存在差异。根据我们的研究结果可以推测，ESRD-RRT患者中的BKV感染与尿毒症相关免疫功能障碍所涉及的因素有关，也与不同RRT的特定机制有关。对于接受肾移植的患者，PD可能是一种与更好的移植结果相关的选择。
