ESPN 54th Annual Meeting

ESPN 2022


 
EVALUATION OF BK VIRUS FREQUENCY AND ITS RELATIONSHIP WITH CLINICAL PARAMETERS IN CHILDREN RECEIVING IMMUNOSUPPRESSIVE TREATMENT FOR KIDNEY DISEASE EXCLUDING TRANSPLANTATION
BUKET UGURTAY 4 ZEYNEP NAGEHAN YURUK YILDIRIM 1 SEVIM MESE 5 CEMILE PEHLIVANOGLU 2 BETUL SOZERI 6 NURVER AKINCI 3 MUSTAFA ONEL 1 BAGDAGUL AKSU 1 ALI AGACFIDAN 5 ALEV YILMAZ 1 AHMET NAYIR 1

1- ISTANBUL UNIVERSITY, ISTANBUL FACULTY OF MEDICINE, DIVISION OF PEDIATRIC NEPHROLOGY
2- ISTANBUL UMRANIYE TRAINING AND RESEARCH HOSPITAL, DIVISION OF PEDIATRIC NEPHROLOGY
3- BEZMIALEM VAKIF UNIVERSITY HOSPITAL, DIVISION OF PEDIATRIC NEPHROLOGY
4- ISTANBUL UNIVERSITY, ISTANBUL FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRICS
5- ISTANBUL UNIVERSITY, ISTANBUL FACULTY OF MEDICINE, DEPARTMENT OF MICROBIOLOGY
6- ISTANBUL UMRANIYE RESEARCH AND TRAINING HOSPITAL, DIVISION OF PEDIATRIC RHEUMATOLOGY
 
Introduction:

The full spectrum of BKV-related kidney diseases in immunocompromised patients remains unclear. The aim of our study was to evaluate the frequency of BK viruria and viremia in patients who received immunosuppressive treatment due to kidney diseases other than transplantation and to evaluate its relationship with clinical parameters. 

Material and methods:

A total of 46 children, who were using immunosuppressive treatment for kidney disease except renal transplantation and 28 healthy children were included in the study. BKV quantitation was performed in urine and serum samples by real time PCR. 

Results:

Twenty-four (52.2%) patients were receiving only methylprednisolone, rest of the patients were receiving cyclosporine, mycophenolate mofetil, canakinumab, eculizumab, cyclophosphamide (alone or in combination) with or without methylprednisolone at the time of sampling. BKV-DNA was detected in the urine samples of 2 (4.35%) patients while there were no BKV-DNA positivity in plasma samples. One of these patients was being followed up with the diagnosis of systemic lupus erythematosus (SLE) and has been receiving cyclosporine and steroid at the time of sampling. The other with the diagnosis of steroid-dependent nephrotic syndrome and receiving steroid at the time of sampling. Both patients had used cyclophosphamide in the past. Also rituximab was used for the patient with SLE. There were no positivity in the plasma and urine samples of the healthy control group.

Conclusions:

The use of steroids alone as immunosuppressive therapy does not appear to be an important risk factor for BKV reactivation. It does not seem necessary to perform BKV-DNA screening in pediatric patients receiving mild immunosuppressive therapy. It has been thought that BKV reactivation may be more frequent, especially if the underlying disease is SLE or if intense immunosuppression is used, and BKV screening may be performed in these patients.  Our results suggest that frequency of BK viruria and viremia are very low in healthy children.