BKV Nephropathy in Native Kidney
DOI:
https://doi.org/10.31584/psumj.2023256587Keywords:
Native kidney, ไวรัส BK, ยากดภูมิAbstract
BKV nephropathy is the most common disease in kidney transplant recipients, causes from infected BKV in the transplant kidney. However, BKV nephropathy also can be found in the native kidney patients who are immunocompromised such as solid organ transplant, hematologic disease, bone marrow transplantation, human immunodeficiency virus (HIV) disease and autoimmune disease. Mostly renal manifestation is declination of glomerular filtration rate (GFR) in BKV nephropathy of the native kidney, and hemorrhagic cystitis in bone marrow transplantation patients. However, other organs can be infected by BKV and also show other extrarenal manifestation. Kidney biopsy is the gold standard for diagnosis. The histology shows cytopathic change of tubular cell by light microscopy and SV40 positive. Due to limited data of BKV in the native kidney, so treatment in this group still base on treatment in kidney transplant patients which are reduction or cessation of immunosuppressive drugs, or changing medication to mTOR inhibitor or adding adjunctive therapy with cidofovir, leflunomide or IVIG. Although the incidence of BKV nephropathy in the native kidney was low, early diagnosis is very important. Delayed treatment of BKV nephropathy may lead to renal injury, renal failure and need for dialysis finally.
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