Kidney Disease Center, College of Medicine, the First Affiliated Hospital, Zhejiang University, Hangzhou, China.
Key Laboratory of Nephropathy, Hangzhou, China.
Transpl Infect Dis. 2021 Jun;23(3):e13557. doi: 10.1111/tid.13557. Epub 2021 Jan 19.
There is still a lack of a recognized morphological classification of BK viral nephropathy (BKVN) which can better reflect the clinical manifestations and prognosis.
We retrospectively analyzed the data of 53 patients with BKVN in our center from January 2011 to December 2018 and evaluated the new Banff 2018 classifications' predictive value for the graft prognosis.
The period between transplantation and BKVN diagnosis lasted for 10.3 months (IQR, 5.3-21.9 months). The main reason (92.5%) for puncture was the increase of blood serum creatinine. Of the 53 patients diagnosed with BKVN, 100% were positive for urinary BK virus-DNA, and the viral load was 1.4 × 10 copies/mL (IQR, 3.7 × 10 -1.3 × 10 copies/mL); 75.5% were positive for blood BK virus-DNA, and the viral load was 3.3 × 10 copies/mL (IQR, 0-2.8 × 10 copies/mL). There were five cases in class 1, 31 cases in class 2, and 17 cases in class 3; the viral load of urine BK was 3.3 × 10 , 1.4 × 10 , and 6.3 × 10 copies/mL (P > .05); the viral load of blood BK was 3.3 × 10 , 3.3 × 10 , and 3.3 × 10 copies/mL (P > .05); the 1-year graft survival rates were 100%, 90.3%, and 52.9%, respectively (P < .05).
BKVN mostly occurs within 1 year after transplantation. There is no correlation between BK virus load in hematuria and pathological damage at the time of diagnosis. The 2018 Banff Classification for BKVN can better indicate the prognosis of graft.
目前仍缺乏一种能更好地反映 BK 病毒肾病（BKVN）临床表现和预后的公认的形态学分类方法。
我们回顾性分析了 2011 年 1 月至 2018 年 12 月期间在我中心诊断为 BKVN 的 53 例患者的临床资料，并评估了 2018 年新的 Banff 分类系统对移植物预后的预测价值。
从移植到诊断 BKVN 的时间间隔为 10.3 个月（IQR，5.3-21.9 个月）。穿刺的主要原因（92.5%）是血肌酐升高。53 例诊断为 BKVN 的患者中，100%的患者尿 BK 病毒-DNA 阳性，病毒载量为 1.4×10 拷贝/ml（IQR，3.7×10 -1.3×10 拷贝/ml）；75.5%的患者血 BK 病毒-DNA 阳性，病毒载量为 3.3×10 拷贝/ml（IQR，0-2.8×10 拷贝/ml）。其中 1 级 5 例，2 级 31 例，3 级 17 例；尿 BK 病毒载量分别为 3.3×10 、1.4×10 和 6.3×10 拷贝/ml（P>.05）；血 BK 病毒载量分别为 3.3×10 、3.3×10 和 3.3×10 拷贝/ml（P>.05）；1 年移植物存活率分别为 100%、90.3%和 52.9%（P<.05）。
BKVN 多发生在移植后 1 年内。血尿 BK 病毒载量与诊断时的病理损伤无相关性。2018 年 Banff 分类系统能更好地反映 BKVN 移植物的预后。
