Development of BK polyomavirus-associated nephropathy risk prediction in kidney transplant recipients
Background With the development of potential prevention therapies for BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN), risk prediction models are needed to identify kidney transplant recipients at high risk for BKPyVAN.Methods This single-center retrospective study aimed to develop a risk p...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2509785 |
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| author | Junji Yamauchi Katalin Fornadi Divya Raghavan Duha Jweehan Suayp Oygen Silviana Marineci Michelle Buff Michael Fenlon Motaz Selim Michael Zimmerman Miklos Z. Molnar |
| author_facet | Junji Yamauchi Katalin Fornadi Divya Raghavan Duha Jweehan Suayp Oygen Silviana Marineci Michelle Buff Michael Fenlon Motaz Selim Michael Zimmerman Miklos Z. Molnar |
| author_sort | Junji Yamauchi |
| collection | DOAJ |
| description | Background With the development of potential prevention therapies for BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN), risk prediction models are needed to identify kidney transplant recipients at high risk for BKPyVAN.Methods This single-center retrospective study aimed to develop a risk prediction model and an integer-based risk score for BKPyVAN development, defined as plasma BKPyV-DNA >10,000 copies/mL and/or biopsy-proven BKPyVAN, within 1-year post-transplant, using donor and recipient characteristics at the time of transplantation. We randomly split patients into development and validation cohorts and applied logistic regression with backward selection to identify significant variables. Model performance was evaluated using the area under the receiver-operating characteristic curve (AUC) and calibration plots.Results This study included 560 patients, of whom 75 (13%) patients had BKPyVAN. Age >50 years, male sex, and prior kidney transplant were selected for the final model. The total integer score ranged from 0 to 4 points, with 1 point assigned for age >50 years and male sex, and 2 points for prior kidney transplant. The AUC was 0.65 in both development and validation cohorts. Calibration plots showed an incremental increase in risk with higher total scores. The integer score indicated that patients with a total score of 2 or higher (i.e. males aged >50 years or those with prior kidney transplants) have a predicted risk of 20% or greater.Conclusion Although the AUC was suboptimal, the results suggest that our model may still be valuable for identifying high-risk patients. |
| format | Article |
| id | doaj-art-0b1546b5fbd04e39a19cd1dad676c1d0 |
| institution | DOAJ |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-0b1546b5fbd04e39a19cd1dad676c1d02025-08-20T03:05:35ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2509785Development of BK polyomavirus-associated nephropathy risk prediction in kidney transplant recipientsJunji Yamauchi0Katalin Fornadi1Divya Raghavan2Duha Jweehan3Suayp Oygen4Silviana Marineci5Michelle Buff6Michael Fenlon7Motaz Selim8Michael Zimmerman9Miklos Z. Molnar10Division of Nephrology & Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Transplantation and Advanced Hepatobiliary Surgery, Department of Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Nephrology & Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Nephrology & Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Nephrology & Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Nephrology & Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Transplantation and Advanced Hepatobiliary Surgery, Department of Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Transplantation and Advanced Hepatobiliary Surgery, Department of Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Transplantation and Advanced Hepatobiliary Surgery, Department of Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Transplantation and Advanced Hepatobiliary Surgery, Department of Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USADivision of Nephrology & Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USABackground With the development of potential prevention therapies for BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN), risk prediction models are needed to identify kidney transplant recipients at high risk for BKPyVAN.Methods This single-center retrospective study aimed to develop a risk prediction model and an integer-based risk score for BKPyVAN development, defined as plasma BKPyV-DNA >10,000 copies/mL and/or biopsy-proven BKPyVAN, within 1-year post-transplant, using donor and recipient characteristics at the time of transplantation. We randomly split patients into development and validation cohorts and applied logistic regression with backward selection to identify significant variables. Model performance was evaluated using the area under the receiver-operating characteristic curve (AUC) and calibration plots.Results This study included 560 patients, of whom 75 (13%) patients had BKPyVAN. Age >50 years, male sex, and prior kidney transplant were selected for the final model. The total integer score ranged from 0 to 4 points, with 1 point assigned for age >50 years and male sex, and 2 points for prior kidney transplant. The AUC was 0.65 in both development and validation cohorts. Calibration plots showed an incremental increase in risk with higher total scores. The integer score indicated that patients with a total score of 2 or higher (i.e. males aged >50 years or those with prior kidney transplants) have a predicted risk of 20% or greater.Conclusion Although the AUC was suboptimal, the results suggest that our model may still be valuable for identifying high-risk patients.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2509785BK polyomavirusBK polyomavirus-associated nephropathykidney transplantationrisk predictioninteger risk score |
| spellingShingle | Junji Yamauchi Katalin Fornadi Divya Raghavan Duha Jweehan Suayp Oygen Silviana Marineci Michelle Buff Michael Fenlon Motaz Selim Michael Zimmerman Miklos Z. Molnar Development of BK polyomavirus-associated nephropathy risk prediction in kidney transplant recipients Renal Failure BK polyomavirus BK polyomavirus-associated nephropathy kidney transplantation risk prediction integer risk score |
| title | Development of BK polyomavirus-associated nephropathy risk prediction in kidney transplant recipients |
| title_full | Development of BK polyomavirus-associated nephropathy risk prediction in kidney transplant recipients |
| title_fullStr | Development of BK polyomavirus-associated nephropathy risk prediction in kidney transplant recipients |
| title_full_unstemmed | Development of BK polyomavirus-associated nephropathy risk prediction in kidney transplant recipients |
| title_short | Development of BK polyomavirus-associated nephropathy risk prediction in kidney transplant recipients |
| title_sort | development of bk polyomavirus associated nephropathy risk prediction in kidney transplant recipients |
| topic | BK polyomavirus BK polyomavirus-associated nephropathy kidney transplantation risk prediction integer risk score |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2509785 |
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