A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients.
<h4>Background</h4>The immunosuppressive agents mycophenolate acid (MPA) and tacrolimus (Tac) are associated with a higher incidence of BK polyomavirus nephropathy (BKPyVAN). In this observational retrospective cohort study, the frequency of BK polyomavirus (BKPyV) complications over a 2...
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0178801&type=printable |
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| author | Lilli Gard Willem van Doesum Hubert G M Niesters Willem J van Son Arjan Diepstra Coen A Stegeman Henk Groen Annelies Riezebos-Brilman Jan Stephan Sanders |
| author_facet | Lilli Gard Willem van Doesum Hubert G M Niesters Willem J van Son Arjan Diepstra Coen A Stegeman Henk Groen Annelies Riezebos-Brilman Jan Stephan Sanders |
| author_sort | Lilli Gard |
| collection | DOAJ |
| description | <h4>Background</h4>The immunosuppressive agents mycophenolate acid (MPA) and tacrolimus (Tac) are associated with a higher incidence of BK polyomavirus nephropathy (BKPyVAN). In this observational retrospective cohort study, the frequency of BK polyomavirus (BKPyV) complications over a 24-month period was studied.<h4>Methods</h4>358 renal transplant recipients (RTR) treated with MPA, with either cyclosporine A (CsA) (CsAM group) or Tac (TacM group) and mostly prednisolone, were included.<h4>Results</h4>Incidence of BKPyV-viremia was not significantly different between the CsAM (n = 42/191) (22.0%) and the TacM (n = 36/167) (21.6%) group. Biopsy proven BKPyVAN occurred more often in the TacM group (6.6%) versus the CsAM group (2.1%) (p = 0.03). Longitudinal data analysis showed a significant earlier decline of viral load in plasma in the CsAM group compared to the TacM group (p = 0.005). The incidence of biopsy proven acute rejection (BPAR) was significantly higher in the CsAM (19.9%) compared to the TacM (10.8%) (p = 0.02) group. Graft loss, estimated glomerular filtration rate and mortality rate did not differ in both treatment groups.<h4>Conclusion</h4>In conclusion, this study shows that immunosuppressive treatment with Tac and MPA compared to CsA and MPA is associated with a lower incidence of BPAR, but at the cost of an increased risk of developing BKPyVAN in the first two years post-transplant. |
| format | Article |
| id | doaj-art-6d0712e5346e434b9535e6ba96a8b08c |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-6d0712e5346e434b9535e6ba96a8b08c2025-08-20T03:13:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01126e017880110.1371/journal.pone.0178801A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients.Lilli GardWillem van DoesumHubert G M NiestersWillem J van SonArjan DiepstraCoen A StegemanHenk GroenAnnelies Riezebos-BrilmanJan Stephan Sanders<h4>Background</h4>The immunosuppressive agents mycophenolate acid (MPA) and tacrolimus (Tac) are associated with a higher incidence of BK polyomavirus nephropathy (BKPyVAN). In this observational retrospective cohort study, the frequency of BK polyomavirus (BKPyV) complications over a 24-month period was studied.<h4>Methods</h4>358 renal transplant recipients (RTR) treated with MPA, with either cyclosporine A (CsA) (CsAM group) or Tac (TacM group) and mostly prednisolone, were included.<h4>Results</h4>Incidence of BKPyV-viremia was not significantly different between the CsAM (n = 42/191) (22.0%) and the TacM (n = 36/167) (21.6%) group. Biopsy proven BKPyVAN occurred more often in the TacM group (6.6%) versus the CsAM group (2.1%) (p = 0.03). Longitudinal data analysis showed a significant earlier decline of viral load in plasma in the CsAM group compared to the TacM group (p = 0.005). The incidence of biopsy proven acute rejection (BPAR) was significantly higher in the CsAM (19.9%) compared to the TacM (10.8%) (p = 0.02) group. Graft loss, estimated glomerular filtration rate and mortality rate did not differ in both treatment groups.<h4>Conclusion</h4>In conclusion, this study shows that immunosuppressive treatment with Tac and MPA compared to CsA and MPA is associated with a lower incidence of BPAR, but at the cost of an increased risk of developing BKPyVAN in the first two years post-transplant.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0178801&type=printable |
| spellingShingle | Lilli Gard Willem van Doesum Hubert G M Niesters Willem J van Son Arjan Diepstra Coen A Stegeman Henk Groen Annelies Riezebos-Brilman Jan Stephan Sanders A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients. PLoS ONE |
| title | A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients. |
| title_full | A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients. |
| title_fullStr | A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients. |
| title_full_unstemmed | A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients. |
| title_short | A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients. |
| title_sort | delicate balance between rejection and bk polyomavirus associated nephropathy a retrospective cohort study in renal transplant recipients |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0178801&type=printable |
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