Comparison of BK Virus Nephropathy Risk Between Double-J-Stent with
Anti-Reflux Mechanism and Standart Double-J-Stent: Single-Center
Experience
Abstract
Objectives: Ureteral stend use is a risk factor for BK nephropathy
(BKVN). In 2015, we compared the patients with anti-reflux mechanism DJS
(ARD-DJS) and those used standard DJS (st-DJS) in terms of BKV and BKVN
frequency in 90 kidney transplant patients in two centers. With the
increase in the number of our patients over time and lengthening of the
follow-up duration, we needed to re-evaluate the data in one center.
Materials and Methods: We retrospectively evaluated 211 patients who
underwent kidney transplantation at Diyarbakır Gazi Yaşargil Training
and Research Hospital between September 2012 and September 2019. The
following parameters were recorded, demographic data, immunosuppression
protocols, presence of rejection, graft loss, plasma BKV levels, and
presence of BKVN. Median and IQR follow-up time for ARD-DJS and St-DJS
patients was 72 months (62,5-80,3 months) and 27,8 months (17,4-39,6
months) respectively. Results: Thirteen patients (6,1%) had BKV
viremia. BKVN was revealed by kidney biopsy in 3 of 13 patients.
However, graft loss due to BKVN was observed in only one patient.
ARD-DJS was used in 4 of these cases and standard DJS was used in 9 of
these cases. Patients in whom BKV revealed in the first 3 months were
compared in the aspect of DJS technique, BKV was significantly less
observed in the ARD-DJS group (ARD-DJS: 2 patients; St-DJS:9 patients),
(p=0,046). Conclusions: In our study, BKV was observed less in patients
with ARD-DJS that were clinically significant but not statistically
significant. Therefore, prospective randomized studies with high patient
numbers are needed to determine the effectiveness of ARD-DJS.