Everolimus for BKV nephropathy in kidney transplant recipients: a prospective, controlled study.

Journal of Nephrology
Elisabetta BussalinoErnesto Paoletti

Abstract

There is no specific therapy for polyoma BK virus nephropathy (BKVN) in kidney transplant recipients, a condition associated with poor outcomes. Everolimus showed promising antiviral effects, but data from prospective studies are limited. Therefore, we converted ten consecutive kidney transplant recipients with biopsy-proven BKVN from standard exposure Calcineurin inhibitors and Mycophenolate to Everolimus and reduced exposure Calcineurin inhibitors. Ten patients not administered Everolimus, on reduced exposure Calcineurin inhibitor and halved MPA doses served as controls. All kidney transplant recipients continued steroid therapy. Each patient underwent kidney graft biopsy, BKV replication by PCR, and de novo DSA determination. During a 3-year follow-up no graft loss occurred in kidney transplant recipients on Everolimus but it was observed in 5/10 controls (P = 0.032). eGFR improved on Everolimus and worsened in controls (between group difference + 25.6 ml/min/1.73 m2, 95% CI 10.5-40.7, P = 0.002). BKV replication declined in the Everolimus group alone (from 6.4 ± 0.8 to 3.6 ± 1.6 Log 10 genomic copies, P = 0.0001), and we found a significant inverse relationship between eGFR and BKV genomic copy changes (P = 0.022). Average ...Continue Reading

References

Jul 31, 2008·Transplant Infectious Disease : an Official Journal of the Transplantation Society·P D AcottJ F S Crocker
Jun 23, 2009·Nature·Koichi ArakiRafi Ahmed
Nov 26, 2009·Transplantation·Adrian EgliHans H Hirsch
May 31, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Y J LiY C Tian
Mar 8, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·H H HirschUNKNOWN AST Infectious Diseases Community of Practice
Jan 30, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M HaasUNKNOWN Banff meeting report writing committee
Feb 28, 2014·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Deirdre Sawinski, Simin Goral
Dec 3, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Tom GreeneAndrew S Levey
Dec 8, 2015·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·H H HirschJ Manzetti
Aug 9, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A NoceraF Ginevri
Oct 18, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·F J BemelmanJ J Homan van der Heide
Dec 28, 2017·Journal of the American Society of Nephrology : JASN·Volker NickeleitUNKNOWN Banff Working Group on Polyomavirus Nephropathy
Jan 26, 2018·Transplantation·Lyndsey J BowmanChristina T Doligalski
Sep 23, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Deirdre Sawinski, Jennifer Trofe-Clark
Mar 31, 2019·Journal of Nephrology·Claudio Ponticelli, Richard J Glassock
Apr 28, 2019·Journal of Nephrology·Ernesto PaolettiUNKNOWN ENTROPIA Project
Jun 21, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Tomas ReischigMirko Bouda

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Citations

Aug 22, 2020·International Journal of Nephrology and Renovascular Disease·Rajeev Sharma, Mareena Zachariah
Aug 3, 2021·Frontiers in Medicine·Sergi CodinaJosep M Cruzado

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