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Study compares strategies for BK virus nephropathy
Date:11/26/2008

8 percent of patients treated by the "withdrawal" strategy, compared to 56 percent with the "reduction" strategy. Early withdrawal of immunosuppressive drugswithin one month after the diagnosis of BKVANreduced the risk of graft loss by two-thirds.

Another treatment, called depleting antibody induction, was associated with a fourfold increase in the risk of graft loss. All of the treatment differences remained significant after adjustment for other factors.

Outcomes were much better when BKVAN was managed by specialists at the transplant center. For these patients, the risk of graft loss was eleven times lower than for patients managed by the patient's home nephrologist, in cooperation with the transplant center. This may have partially reflected the large number of patients from rural areas, drawn from five Western states, treated at the University of Colorado transplant center.

The results highlight the need for increased awareness and early diagnosis of BKVAN, with "aggressive tapering of immunosuppression" as soon as the diagnosis is made, according to Dr. Wiseman. "Our study also identifies a potential need for the general nephrology community to adopt screening strategies for BKVAN, and to understand the prevalence and severity of the disease outside the transplant center." Dr. Wiseman also notes some limitations of the study, including the fact that it was retrospective in nature and did not include a large percentage of black patients.


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Contact: Shari Leventhal
sleventhal@asn-online.org
202-416-0658
American Society of Nephrology
Source:Eurekalert

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