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OBJECTIVE: To review the first year of a monthly urine cytology screening service, introduced to identify renal transplant patients at risk of polyoma virus nephropathy (PVN), at an early, potentially treatable, stage. METHODS AND RESULTS: Monthly urine samples (n = 392) were received from 97/108 transplant recipients in 2005. Of 56 patients with follow-up >6 months, 20% and 9% had significant (>10 decoy cells/cytospin) and non-significant positive cytology, respectively. The first positive urine samples occurred most commonly in the second and third month post-transplantation and patients with significantly positive samples had higher 3-month and 6-month serum creatinine levels than patients with negative urine cytology (p<0.01). Four patients with positive urine cytology had a subsequent positive plasma BK virus PCR; 3/97 patients had biopsy-proven PVN, all in the third month, 1-6 weeks after first positive urine samples. CONCLUSIONS: Significant PV viruria is common following renal transplantation with onset usually within the first 3 months. Viruria is associated with worse graft function at 3 and 6 months. The time between urine positivity and clinical PVN is short. More frequent early urine screening would be required to achieve clinical benefit.

Original publication

DOI

10.1136/jcp.2006.042507

Type

Journal article

Journal

J Clin Pathol

Publication Date

08/2007

Volume

60

Pages

927 - 930

Keywords

Anti-Infective Agents, Ciprofloxacin, Humans, Immunosuppression, Kidney Diseases, Kidney Transplantation, Polymerase Chain Reaction, Polyomavirus, Polyomavirus Infections, Postoperative Complications, Tumor Virus Infections