Incidence and Risk Factors for High-level BK Viruria -A Single Center Study in China

Abstract Background BK Virus Allograft Nephropathy (BKVAN) is a serious complication after kidney transplantation, and the effect of pre-emptive intervention for high-level BK viruria has been verified, but the protocols after kidney transplantation for early identification of high-level viruria is lacking.Methods This was a single-center respectively study. The clinical data of the kidney transplant recipients and their donors in our center from January 1, 2015 to December 31, 2018 were collected. According to the qPCR results of BK virus DNA loads in urine samples, the patients were divided into high-level BK Viruria Group (Group A) and none high-level BK Viruria Group (Group B). Significant variables were screened out by univariate analysis, and then the results were incorporated into multivariate logistic regression model to analyze the independent risk factors of high-level BK viruria.Results A total of 262 recipients were included in the study. The incidence of high-level BK viruria was 13.4% (n=35), and the median time of detection was 181(range 91~1119) days. Univariate analysis showed that the donor type ( =21.770, P < 0.001), history of ATG/ATG-F application ( =4.543, P=0.033), Acute Rejection (AR) ( =8.313, P=0.004) and Delayed Graft Function (DGF) ( =21.170, P < 0.001) were related with high-level BK viruria. After the inclusion of multivariate logistic regression model, the results showed that brain and cardiac deceased donors (P=0.032,OR=3.927, 95%CI:1.122~13.746), AR (P=0.022,OR=4.709, 95%CI:1.253~17.697) and DGF (P=0.001,OR=6.682, 95%CI:2.288~19.518).Conclusions Donation of Brain and Cardiac Deceased, history of AR, DGF were independent risk factors for high-level BK viruria after kidney transplantation.