Early disappearance of urinary decoy cells in successfully treated polyomavirus BK nephropathy

Y. Matsukuma, K. Masutani, akihiro tsuchimoto, Yasuhiro Okabe, H. Kitada, H. Noguchi, M. Tanaka, K. Tsuruya, Takanari Kitazono

Research output: Contribution to journalArticle

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Abstract

Background Polyomavirus BK nephropathy (BKVN) is an important infectious complication in kidney transplant patients. Regular screening using polymerase chain reaction for BK virus DNA in plasma and urinary cytology is effective for early diagnosis of BKVN. However, methods of follow-up and therapeutic targets are not well described. Methods Ten patients with BKVN who received biweekly urinary cytology and repeat biopsies after diagnosis were retrospectively studied. Histological remission of BKVN was determined when biopsy revealed negative SV40 large T-antigen (TAg) staining. Results of urinary cytology and repeat biopsy findings were compared. Results Urinary decoy cells disappeared in 8 of 10 patients 55 ± 25 (range 13-79) days after index biopsies. In those cases, allograft function was preserved and the final serum creatinine level was 2.14 ± 1.19 (0.80-4.55) mg/dL after 962 ± 393 (325-1563) days of follow-up. Two cases with persistent urinary decoy cells shedding lost their graft 195 and 362 days later. Amongst 29 repeat biopsies, there were 13 TAg-positive and 16 negative biopsies. In 12 of 13 TAg-positive biopsies (92%), urinary decoy cells were still positive, whereas at the same time in 15 TAg-negative biopsies, decoy cells had already disappeared (94%). Conclusions Cytology testing is advantageous because of its cost effectiveness. Clearance of decoy cells from urine was closely related to histological remission of BKVN, and may possibly be a therapeutic target in BKVN.

Original languageEnglish
Pages (from-to)560-563
Number of pages4
JournalTransplantation Proceedings
Volume46
Issue number2
DOIs
Publication statusPublished - Jan 1 2014

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BK Virus
Biopsy
Viral Tumor Antigens
Cell Biology
Polyomavirus Transforming Antigens
Transplants
Cost-Benefit Analysis
Allografts
Early Diagnosis
Creatinine
Urine
Staining and Labeling
Kidney
Polymerase Chain Reaction
DNA

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

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Early disappearance of urinary decoy cells in successfully treated polyomavirus BK nephropathy. / Matsukuma, Y.; Masutani, K.; tsuchimoto, akihiro; Okabe, Yasuhiro; Kitada, H.; Noguchi, H.; Tanaka, M.; Tsuruya, K.; Kitazono, Takanari.

In: Transplantation Proceedings, Vol. 46, No. 2, 01.01.2014, p. 560-563.

Research output: Contribution to journalArticle

Matsukuma, Y. ; Masutani, K. ; tsuchimoto, akihiro ; Okabe, Yasuhiro ; Kitada, H. ; Noguchi, H. ; Tanaka, M. ; Tsuruya, K. ; Kitazono, Takanari. / Early disappearance of urinary decoy cells in successfully treated polyomavirus BK nephropathy. In: Transplantation Proceedings. 2014 ; Vol. 46, No. 2. pp. 560-563.
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abstract = "Background Polyomavirus BK nephropathy (BKVN) is an important infectious complication in kidney transplant patients. Regular screening using polymerase chain reaction for BK virus DNA in plasma and urinary cytology is effective for early diagnosis of BKVN. However, methods of follow-up and therapeutic targets are not well described. Methods Ten patients with BKVN who received biweekly urinary cytology and repeat biopsies after diagnosis were retrospectively studied. Histological remission of BKVN was determined when biopsy revealed negative SV40 large T-antigen (TAg) staining. Results of urinary cytology and repeat biopsy findings were compared. Results Urinary decoy cells disappeared in 8 of 10 patients 55 ± 25 (range 13-79) days after index biopsies. In those cases, allograft function was preserved and the final serum creatinine level was 2.14 ± 1.19 (0.80-4.55) mg/dL after 962 ± 393 (325-1563) days of follow-up. Two cases with persistent urinary decoy cells shedding lost their graft 195 and 362 days later. Amongst 29 repeat biopsies, there were 13 TAg-positive and 16 negative biopsies. In 12 of 13 TAg-positive biopsies (92{\%}), urinary decoy cells were still positive, whereas at the same time in 15 TAg-negative biopsies, decoy cells had already disappeared (94{\%}). Conclusions Cytology testing is advantageous because of its cost effectiveness. Clearance of decoy cells from urine was closely related to histological remission of BKVN, and may possibly be a therapeutic target in BKVN.",
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