Intermediate‐dose cidofovir without probenecid in the treatment of BK virus allograft nephropathy

@article{Araya2006IntermediatedoseCW,
  title={Intermediate‐dose cidofovir without probenecid in the treatment of BK virus allograft nephropathy},
  author={Carlos Enrique Araya and Judy. Lew and Robert S. Fennell and Richard E. Neiberger and Vikas R. Dharnidharka},
  journal={Pediatric Transplantation},
  year={2006},
  volume={10}
}
Abstract:  BK virus allograft nephropathy (BKVAN) is a rising complication in kidney transplant recipients. Reducing immunosuppression has been the initial form of therapy in most cases, but is not always associated with improvement in graft function. Anti‐viral therapy with low‐dose cidofovir (0.25–0.42 mg/kg/dose) has been used successfully in some patients, but dose‐related nephrotoxicity has limited its use. We present our experience with 3 kidney transplant recipients diagnosed with BKVAN… 
Intermediate dose cidofovir does not cause additive nephrotoxicity in BK virus allograft nephropathy
TLDR
In this larger series with extended follow up, intermediate dose cidofovir without probenecid for the treatment of BKVAN continues to show stabilization of renal function without progression to renal failure.
Leflunomide therapy for BK virus allograft nephropathy after pediatric kidney transplantation
TLDR
Leflunomide therapy in addition to a reduction of the immunosuppressive therapies resulted in a significant decline in the BK viral load without further deterioration of renal function.
Low-dose Cidofovir for the Treatment of Polyomavirus-Associated Nephropathy: Two Case Reports and Review of the Literature
TLDR
In vitro and clinical data to support the efficacy of cidofovir in the treatment of PVAN are currently lacking and more promising compounds should be identified for further clinical studies.
Efficacy and adverse effects of cidofovir for treatment of BK virus infection in kidney transplant recipients
TLDR
This review aims to present the current literature on the efficacy, potential adverse effects and cost-effectiveness of cidofovir treatment for BK viremia/nephropathy.
Intravenous immunoglobulin as rescue therapy for BK virus nephropathy
TLDR
Stabilization of renal functions, histological resolution of BKVN and significant reduction in BK viremia in pediatric renal transplant with the use of IVIg, after an inadequate response to immunosuppression reduction and cidofovir therapy.
The effect of low-dose cidofovir on the long-term outcome of polyomavirus-associated nephropathy in renal transplant recipients.
  • Sheng-Wen Wu, Horng-Rong Chang, J. Lian
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2009
TLDR
There was no obvious effect of low-dose cidofovir on long- term graft survival in patients with PVAN, and acute rejection prior to PVAN diagnosis was a potential risk factor for poorer long-term graft outcome.
BK virus infection, replication, and diseases in pediatric kidney transplantation
TLDR
Larger prospective trials are needed to better define the impact of BK virus immunity for replication and disease as well as the role of reducing immunosuppression with or without cidofovir or leflunomide in pediatric transplant patients.
BK nephropathy in the native kidneys of patients with organ transplants: Clinical spectrum of BK infection
TLDR
In patients with solid organ transplants, bone marrow transplants and in patients with other clinical entities associated with immunosuppression, BK nephropathy of the native kidneys has being increasingly recognized as a cause of chronic kidney disease.
Coexistence of tubulointerstitial and glomerular lesions in a renal transplantation recipient with BK virus infection: response to cidofovir
TLDR
A 49 year -old patient who developed polyomavirus BK nephropathy eight months after receiving a renal transplant, expressed as an increase in proteinuria, hypertension, and a rise in serum creatinine levels is presented.
Antivirals for the treatment of polyomavirus BK replication
TLDR
This work reviews the antiviral strategies explored to date and discusses available in vivo and in vitro data on cidofovir, leflunomide, fluoroquinolones and intravenous immunoglobulins, regarding mechanism, administration, dosing and outcome and provides a perspective on future therapy options.
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References

SHOWING 1-10 OF 28 REFERENCES
Treatment of Refractory BK Virus‐Associated Nephropathy With Cidofovir
  • Pradeep V. Kadambi, M. Josephson, A. Limaye
  • Medicine, Biology
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2003
TLDR
Preliminary data suggest that low‐dose cidofovir may be tolerated, even among renal transplant recipients with significant renal dysfunction due to BKVN, and Prospective, controlled trials are warranted to further define the optimal dose, toxicity and potential role of cid ofovir in renal transplant recipient with BK virus nephropathy.
Quantitative viral load monitoring and cidofovir therapy for the management of BK virus-associated nephropathy in children and adults1
TLDR
Quantitative PCR for BKV is a sensitive and reliable method for following the course of the infection in renal transplant patients and cidofovir therapy may be useful in the treatment of some of these patients, and its role needs to be investigated further.
Treatment of polyomavirus infection with cidofovir in a renal-transplant recipient.
60–70% ofhealthy adults are serologically positive) [1]. Recently,there has been an increased awareness of BK-virusnephropathy (BKN) as a new complication affectingrenal allografts and causing graft
Use of cidofovir in polyomavirus BK viral nephropathy in two renal allograft recipients
TLDR
Two cases of BK viral allograft nephropathy responding to low‐dose cidofovir after a reduction in immunosuppressive medications failed to clear the virus or stabilize the deterioration in renal function are described.
Clinical course of polyoma virus nephropathy in 67 renal transplant patients.
TLDR
It is concluded that PVN is a serious hazard for renal transplant recipients and contributes directly to graft loss and antiviral drugs are needed, as the reduction of immunosuppression alone may not significantly improve graft function in patients with already established PVN.
Polyomavirus nephropathy: morphology, pathophysiology, and clinical management
TLDR
Risk assessment after transplantation and patient management during ongoing viral nephropathy have undergone revision by the introduction of real time quantitative polymerase chain reaction techniques measuring BK-virus genome load fluctuations in the serum.
Incidence of polyomavirus-nephropathy in renal allografts: influence of modern immunosuppressive drugs.
  • M. Mengel, M. Marwedel, H. Kreipe
  • Medicine, Biology
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2003
TLDR
A small group of patients under intensive immunosuppression comprising tacrolimus in combination with mycophenolate mofetil has a significantly increased risk of acquiring this deleterious complication.
Human polyoma virus-associated interstitial nephritis in the allograft kidney.
TLDR
Polyoma virus tubulo-interstitial nephritis-associated graft dysfunction usually calls for judicious decrease in immunosuppression and monitoring for acute rejection, and development of methods to serially quantify the viral load in individual patients could potentially improve clinical outcome.
The high incidence of BK polyoma virus infection among renal transplant recipients in India.
TLDR
Routine histologic examination, immunohistochemistry, and electron microscopy were used to retrospectively screen for BK polyoma virus in 414 renal allograft biopsy specimens from 321 transplant recipients presenting with allografted dysfunction, suggesting a high incidence of this infection in Indian transplant recipients.
BK virus and SV40 co-infection in polyomavirus nehropathy1
TLDR
Molecular evidence that co-infection with BKV and SV40 occurs in renal transplant patients with PVN is reported, suggesting that SV40 may contribute to PVN after renal transplant.
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