CHRONOLOGY OF THE DEVELOPMENT OF BK-POLYOMAVIRUSES INFECTION IN PATIENTS AFTER KIDNEY TRANSPLANTATION

Abstract

Kidney allotransplantation currently is a routine method of radical treatment of end-stage renal disease. In the early post-transplant period, the main causes of kidney transplant dysfunction are acute rejection crises and infectious complications. Intensive immunosuppressive therapy is considered to be one of the main risk factors for infectious complications. Viruses cause at least 50% of all infections in kidney transplant recipients. BKpolyomavirus-associated graft dysfunction is a serious disease in patients after kidney translantation, the incidence of which varies from 1% to 10%, with the percentage of loss of graft function reaches 80%. The aim of the work was to study the chronology of the development of BK infection during the first year after kidney transplantation and to monitoring the functional state of the kidneys in recipients with polyomavirus infection. The object and methods of research. There are 50 patients with transplanted kidneys during the first year after transplantation were examined. Results and consideration. The frequency of detection of BK viruria and/or viremia was 24%. The frequency of viruria for BK-polyomavirus was 10 cases (20%), the frequency of BK viremia was 8 cases (16%), simultaneous detection of the virus in blood and urine was observed in 6 cases (12%). During the first year after transplantation, the first cases of laboratory detection of polyomavirus were reported 3 weeks after surgery, with a gradual increase in the level of registration in recipients to 24% for 2 months, followed by a decrease to 8% for the 5th month and episodic detection of the virus by the end of the 1st year. Analysis of the values of indicators of renal functional status in patients of group II revealed a significant decrease of GFR, as well as higher figures of creatinine and urea of blood and albuminuria compared with patients of group I (p< 0.05). When the virus disappeared from the blood and urine, the functional state of the kidneys improved. There was no significant difference between the type of calcineurin inhibitor (cyclosporine or tacrolimus) that the recipient took and the functional state of the kidneys (p=0.001). There was no significant difference between the indicators of clinical blood analysis in patients of group II compared with patients of group I. Conclusions. Activation of BK polyomavirus infection is a common problem that is underestimated in patients after kidney transplantation. It is associated with a decrease of function of the kidney transplant and requires mandatory monitoring. During the first year after surgery, there is a tendency to activate the BK virus from 3 weeks to 5 months after transplantation, which leads to a deterioration in the functional state of the kidney transplant.

Keywords

• chronic kidney disease
• kidney transplantation
• poliomavirus infection
• viremia
• viruria.