Diagnostic accuracy of PCR in detection of BK virus-associated nephropathy in kidney transplant patients in Tabriz Imam Reza hospital

Abstract

BKV is a highly prevalent and low-complication poliovirus that has a prevalence of 90-80% in adults. Significance of poliovirus nephropathy was associated with the introduction of new immunosuppressive drugs. The disease is usually associated with BKV and affects up to 80% of recipients, often leading to permanent loss or dysfunction that increases An asymptomatic gradual increase in creatinine with a tubulointerstitial nephritis that mimics graft rejection. The aim of this study was to evaluate the diagnostic accuracy of PCR method in identifying BK Virus Nephropathy in kidney transplant patients of Imam Reza Hospital. Materials and Methods: In this cross-sectional study, the records of kidney transplant patients who underwent kidney biopsy in Imam Reza Hospital from April 2015 to June 2016 were extracted. Information about performing PCR test in the period of one month before biopsy was sought in patients' files. Those patients who did not undergo PCR blood samples within one month prior to kidney biopsy were excluded from the study (because the information required for our study in these patients is incomplete). The rest of the patients (kidney transplant patients who underwent both kidney biopsy and PCR test results are available) were included in the study. Results: A total of 51 patients were included in the study. The mean age of the patients was 53.84±9.9 years ranging from 39 to 75 years and most of the patients were male. PCR-BKV test was positive in urine samples in 58.8% and in peripheral blood samples in 52.9%. In contrast, biopsy results of all patients, which was the gold standard for the diagnosis of BKV nephropathy, were positive in only 13.7% of patients (7 patients). Evaluation of diagnostic accuracy of PCR test in the present study showed that this test was 100% sensitive in both urine and blood samples but had low specificity. In contrast, the negative predictive value of PCR test in both samples was 100%.