Combined detection of urine specific gravity and BK viruria on prediction of BK polyomavirus nephropathy in kidney transplant recipients  

作　　者：Xu-Tao Chen Ze-Yuan Wang Yang Huang Jin-Yuan Wang Shi-Cong Yang Wen-Fang Chen Pei-Song Chen Jun Li Rong-Hai Deng Gang Huang 

机构地区：[1]Department of Organ Transplantation.The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou.Guangdong 510080,China [2]Zhongshan School of Medicine.Sun Yat-Sen University,Guangzhou.Guangdong 510080.China [3]Department of Pathology,The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou,Guangdong 510080,China [4]Department of Clinical Laboratory,The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou,Guangdong 510080,Chin

出　　处：《Chinese Medical Journal》2020年第1期33-40,共8页中华医学杂志（英文版）

基　　金：This work was supported by grants from the National Natural Science Foundation of China(No.81770749);the Natural Science Foundation of Guangdong Province(No.2017A030313710);the Basic Scientific Research Fund of Sun Yat-Sen University(No.17ykpy29).

摘　　要：Background:BK polyomavirus(BKPyV)-associated nephropathy(BKPyVAN)is an important cause of dysfunction and failure of renal transplants.This study aimed to assess the diagnostic performance of morning urine specific gravity(MUSG)in diagnosing BKPyVAN in kidney transplant recipients.Methods:A total of 87 patients,including 27 with BKPyVAN,22 with isolated BKPyV viruria,18 with T cell-mediated rejection(TCMR),and 20 with stable graft function,were enrolled in the First Affiliated Hospital of Sun Yat-Sen University from March 2015 to February 2017.MUSG at biopsy and during a follow-up period of 24 months after biopsy was collected and analyzed.Receiver operating characteristic(ROC)curve analysis was used to determine the ability of MUSG to discriminate BKPyVAN.Results:At biopsy,the MUSG of BKPyVAN group(1.008±0.003)was significantly lower than that of isolated BK viruria group(1.013±0.004,P<0.001),TCMR group(1.011±0.003,P=0.027),and control group(1.014±0.006,P<0.001).There was no significant difference in MUSG among the isolated BK viruria group,TCMR group,and control group(P=0.253).In BKPyVAN group,the timing and trend of MUSG elevate were consistent with the timing and trend of the decline of viral load in urine and plasma,reaching a statistical difference at 3 months after treatment(1.012±0.003,P<0.001)compared with values at diagnosis.ROC analysis indicated that the optimal cut-off value of MUSG for diagnosis of BKPyVAN was 1.009,with an area under the ROC curve(AUC)of 0.803(95%confidence interval[CI]:0.721–0.937).For differentiating BKPyVAN and TCMR,the optimal MUSG cut-off value was 1.010,with an AUC of 0.811(95%CI:0.687–0.934).Conclusion:Combined detection of MUSG and BKPyV viruria is valuable for predicting BKPyVAN and distinguishing BKPyVAN from TCMR in renal transplant recipients.

关 键 词：BK polyomavirus Kidney transplantation NEPHROPATHY REJECTION URINALYSIS 

分 类 号：R692[医药卫生—泌尿科学]