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REVIEW ARTICLE
Year : 2020  |  Volume : 20  |  Issue : 3  |  Page : 127-150

BK virus infection in renal transplant recipients: an overview


1 Department of Nephrology, Dubai Hospital, Dubai Health Authority, Dubai; Faculty of Medicine, Institute of Clinical Sciences, University of Liverpool, Liverpool, UK
2 Faculty of Medicine, Institute of Clinical Sciences, University of Liverpool, Liverpool; Department of Renal, Doncaster Royal Infirmary, Doncaster, UK
3 Faculty of Medicine, Institute of Clinical Sciences, University of Liverpool, Liverpool, UK
4 Department of Nephrology and Transplantation, Royal Liverpool University Hospital, Liverpool, UK
5 Faculty of Medicine, Institute of Clinical Sciences, University of Liverpool, Liverpool; Department of Nephrology and Transplantation, Royal Liverpool University Hospital, Liverpool, UK
6 Faculty of Medicine, Institute of Clinical Sciences, University of Liverpool, Liverpool; Department of Nephrology and Transplantation, Sheffield Kidney Institute, Sheffield Teaching Hospitals, Sheffield, UK

Correspondence Address:
Dr. Fakhriya Alalawi
Department of Nephrology, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jesnt.jesnt_48_19

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Although BK virus (BKV) was discovered in 1971, it took almost three decades for this virus to be routinely considered as a possibility among a plethora of causes of renal dysfunction in a kidney transplant recipient. BKV infection, an early complication of renal transplant, often presents within the first year after transplantation. It presents as an asymptomatic gradual rise in creatinine with tubulointerstitial nephritis that mimics acute rejection and poses a diagnostic and therapeutic dilemma. More frequent diagnosis of BKV infection over the past 2 decades is a consequence of more potent immunosuppression (aimed to prevent acute rejection episodes and, thereby, improving allograft survival). Untreated BKV infections cause renal allograft dysfunction and subsequently allograft loss. A routine screening protocol for early recognition of asymptomatic BKV infection has been reported to result in better allograft outcomes. This review is aimed to discuss the most recent evidence addressing the virology, pathogenesis, clinical features, diagnostic tools, screening protocols, treatment strategy, and short-term and long-term renal allograft survival concerning BKV infection.


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