Featured Research

from universities, journals, and other organizations

Strategies For BK Virus Nephropathy Compared

Date:
November 26, 2008
Source:
American Society of Nephrology
Summary:
For kidney transplant recipients with a serious complication called BK virus-associated nephropathy, promptly cutting back on anti-rejection drugs reduces the risk of losing the kidney, according to a new report.

For kidney transplant recipients with a serious complication called BK virus-associated nephropathy (BKVAN), promptly cutting back on anti-rejection drugs reduces the risk of losing the kidney (graft loss), according to a new report.

"Our study is the first that demonstrates differences in outcomes when comparing two different immunosuppression tapering approaches in BKVAN, an increasingly prevalent, discouraging problem after kidney transplantation," comments Alexander C.Wiseman, MD, of the University of Colorado at Denver Health Sciences Center, one of the study authors.

The researchers compared the results of competing strategies for reducing immunosuppressive therapy in kidney transplant recipients with BKVAN. "Recognized slightly more than 10 years ago, BKVAN is caused by reactivation of a virus that exists latent in about 80 percent of all human kidneys," explains Dr. Wiseman. In healthy people, the BK virus is harmless.

However, in patients receiving immunosuppressive drugs to prevent rejection after kidney transplantation, the BK virus can become reactivated. "BKVAN occurs in two to 10 percent of kidney transplant recipients, routinely causing irreversible graft injury with a high frequency of graft loss," says Dr. Wiseman.

Of 910 patients receiving kidney transplants between 1999 and 2005, 3.8 percent developed BKVAN. Of these, 46 percent eventually lost the transplanted kidney. One group of patients was treated using a "withdrawal" strategy, in which the number of immunosuppressive drugs was cut back from three to two. Another group was treated by a "reduction" strategy, with a reduced dose of all three medications. The idea is that cutting back on anti-rejection drugs will allow the body's immune system to become strong enough to fight off the BK virus.

One year later, the transplanted kidney was still functioning in 88 percent of patients treated by the "withdrawal" strategy, compared to 56 percent with the "reduction" strategy. Early withdrawal of immunosuppressive drugs—within one month after the diagnosis of BKVAN—reduced 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.


Story Source:

The above story is based on materials provided by American Society of Nephrology. Note: Materials may be edited for content and length.


Journal Reference:

  1. Aggressive Immunosuppression Minimization Reduces Graft Loss Following Diagnosis of BK Virus-Associated Nephropathy: A Comparison of Two Reduction Strategies. Clinical Journal of the American Society of Nephrology, November 2008

Cite This Page:

American Society of Nephrology. "Strategies For BK Virus Nephropathy Compared." ScienceDaily. ScienceDaily, 26 November 2008. <www.sciencedaily.com/releases/2008/11/081126122215.htm>.
American Society of Nephrology. (2008, November 26). Strategies For BK Virus Nephropathy Compared. ScienceDaily. Retrieved July 23, 2014 from www.sciencedaily.com/releases/2008/11/081126122215.htm
American Society of Nephrology. "Strategies For BK Virus Nephropathy Compared." ScienceDaily. www.sciencedaily.com/releases/2008/11/081126122215.htm (accessed July 23, 2014).

Share This




More Health & Medicine News

Wednesday, July 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Stone Fruit Listeria Scare Causes Sweeping Recall

Stone Fruit Listeria Scare Causes Sweeping Recall

Newsy (July 22, 2014) The Wawona Packing Company has issued a voluntary recall on the stone fruit it distributes due to a possible Listeria outbreak. Video provided by Newsy
Powered by NewsLook.com
Huge Schizophrenia Study Finds Dozens Of New Genetic Causes

Huge Schizophrenia Study Finds Dozens Of New Genetic Causes

Newsy (July 22, 2014) The 83 new genetic markers could open dozens of new avenues for schizophrenia treatment research. Video provided by Newsy
Powered by NewsLook.com
CDC Head Concerned About a Post-Antibiotic Era

CDC Head Concerned About a Post-Antibiotic Era

AP (July 22, 2014) Sounding alarms about the growing threat of antibiotic resistance, CDC Director Tom Frieden warned Tuesday if the global community does not confront the problem soon, the world will be living in a devastating post-antibiotic era. (July 22) Video provided by AP
Powered by NewsLook.com
Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins