Wang Jiyan, Li Jiawei, Chen Zhongli, Xu Ming, Yang Cheng, Rong Ruiming, Zhu Tongyu
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Key Laboratory of Organ Transplantation, Shanghai, China.
Front Med (Lausanne). 2022 Feb 10;9:770699. doi: 10.3389/fmed.2022.770699. eCollection 2022.
BK virus is a common opportunistic viral infection that could cause BK virus-associated nephropathy in renal transplant recipients. Thus, we retrospectively analyzed clinical and laboratory data associated with a higher risk of BK virus activation from 195 renal transplant recipients by the multivariate logistic regression analysis and performed the external validation. Results showed that patients with BK virus active infection were associated with a deceased donor, had lower direct bilirubin levels, a higher proportion of albumin in serum protein electrophoresis, and lower red blood cells and neutrophil counts. The multivariate logistic regression analyses revealed that the living donor, direct bilirubin, and neutrophil counts were significantly associated with BK virus activation. The logistic regression model displayed a modest discriminability with the area under the receiver operating characteristic curve of 0.689 (95% CI: 0.607-0.771; < 0.01) and also demonstrated a good performance in the external validation dataset (the area under the receiver operating characteristic curve was 0.699, 95% CI: 0.5899-0.8081). The novel predictive nomogram achieved a good prediction of BK virus activation in kidney transplant recipients.
BK病毒是一种常见的机会性病毒感染，可导致肾移植受者发生BK病毒相关性肾病。因此，我们通过多因素逻辑回归分析对195例肾移植受者中与BK病毒激活高风险相关的临床和实验室数据进行了回顾性分析，并进行了外部验证。结果显示，BK病毒活动性感染患者与已故供体相关，直接胆红素水平较低，血清蛋白电泳中白蛋白比例较高，红细胞和中性粒细胞计数较低。多因素逻辑回归分析显示，活体供体、直接胆红素和中性粒细胞计数与BK病毒激活显著相关。逻辑回归模型在受试者工作特征曲线下面积为0.689（95%CI：0.607-0.771；P<0.01）时显示出适度的辨别能力，并且在外部验证数据集中也表现良好（受试者工作特征曲线下面积为0.699，95%CI：0.5899-0.8081）。新的预测列线图对肾移植受者的BK病毒激活具有良好的预测能力。
