The therapeutic effect of switching from tacrolimus to low-dose cyclosporine A in renal transplant recipients with BK virus nephropathy

There is no effective therapy for BK virus (BKV) nephropathy (BKVN). Cyclosporine A (CsA) has a lower immunosuppressive effect than tacrolimus. studies have shown that CsA inhibits BKV replication. The present study aimed to evaluate the effectiveness of switching from tacrolimus to low-dose CsA in...

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Bibliographic Details
Published in:Bioscience reports 2019-02, Vol.39 (2)
Main Authors: Chen, Xu-Tao, Li, Jun, Deng, Rong-Hai, Yang, Shi-Cong, Chen, Yan-Yang, Chen, Pei-Song, Wang, Ze-Yuan, Huang, Yang, Wang, Chang-Xi, Huang, Gang
Format: Article
Language:English
Subjects:
Adult
BK Virus - isolation & purification
Cyclosporine - administration & dosage
Cyclosporine - therapeutic use
Female
Humans
Immunosuppressive Agents - administration & dosage
Immunosuppressive Agents - therapeutic use
Kidney Diseases - complications
Kidney Diseases - therapy
Kidney Diseases - virology
Kidney Transplantation
Male
Middle Aged
Polyomavirus Infections - complications
Polyomavirus Infections - therapy
Polyomavirus Infections - virology
Tacrolimus - administration & dosage
Tacrolimus - therapeutic use
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Summary:There is no effective therapy for BK virus (BKV) nephropathy (BKVN). Cyclosporine A (CsA) has a lower immunosuppressive effect than tacrolimus. studies have shown that CsA inhibits BKV replication. The present study aimed to evaluate the effectiveness of switching from tacrolimus to low-dose CsA in renal transplant recipients with BKVN. Twenty-four patients diagnosed with BKVN between January 2015 and December 2016 were included. Tacrolimus was switched to low-dose CsA, and patients were followed for 24 months. Primary end points were BKV clearance in blood and graft. Secondary end points were urine specific gravity, serum creatinine, and graft loss. The viremia in all patients cleared at a mean of 2.7 ± 2.0 months after switching to CsA. Urine specific gravity at 3 months after switching to CsA increased significantly compared with that at diagnosis ( =0.002). The timing and trend of urine specific gravity increase was consistent with the timing and trend of blood and urine viral load decrease. Repeated biopsies at a median of 11.2 months (range: 9.1-12.5 months) after switching to CsA showed that 8 patients (42.1%) were negative for BKV, and 11 patients (58.9%) had a decrease in BKV load (
ISSN:0144-8463
1573-4935
DOI:10.1042/BSR20182058