Journal of Clinical Nephrology and Therapeutics

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Journal of Clinical Nephrology and Therapeutics 44 7897 074717

Polyomavirus-Associated Nephropathy

Polyomavirus associated nephropathy (PVAN) was an emerging disease in a renal transplant patients with variable prevalence of 1-10% and graft loss up to 80%. The BK virus (BKV) is the primary etiologic agent, but JC virus (JCV) and possibly simian virus SV40 may account for some cases. Intense immune-suppression was viewed as the most important risk factor. However, the preferential manifestation in renal transplants was compared to the other allografts or to autologous kidneys of other organ transplants to suggests that organ determinants and the immunologic factors synergize: Renal tubular epithelial cells and their compensatory proliferation were to restore the tubular integrity after immunologic, ischemic or toxic injury may provide the critical cellular milieu supporting the polyomavirus replication while immune control was impaired due to the maintenance immunosuppression, anti-rejection treatment and HLA-mismatches. Patient determinants and the viral factors may have a contributory role.

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