Kidney Week

Abstract: PUB347

Association of Ureteral Stent Implantation and BK Polyomavirus Infection After Kidney Transplantation: A Retrospective Case-Control Study

Session Information

• Publication Only

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Hoffmann, Simon, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Simon Hoffmann, MD

• Omic, Haris, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Haris Omic, MD

• Gerges, Daniela, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Daniela Gerges, MD, MSc, PhD

• Eder, Michael, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Michael Eder, MD

• Kikic, Zeljko, Department of Urology, Medical University of Vienna, Vienna, Austria

Zeljko Kikic, MD

Background

Kidney transplantation (KTX) recipients require lifelong immunosuppressive treatment to avoid graft rejection. Opportunistic BK polyomavirus (BKpyV) infection remains a challenge in postoperative care of KTX recipients, due to a lack in specific antiviral treatment options. Sustained BKPyV infection eventually leads to irreversible graft damage in the form of BKpyV associated nephropathy (BKPyVAN). Therefore, identification of risk factors for BKPyV infection is vital in preventing BKpyV infection. Ureteral stent (UrSt) placement has been proposed as a risk factor in various studies. This study aims to investigate the role of UrSt on the risk for BK virus infection.

Methods

All KTX recipients aged ≥18 at the General Hospital Vienna between 2010 and 2021 were retrospectively screened for BKPyV viremia within 12 months post-KTX. Patients with detectable serum BKPyV-DNAemia were classified as cases; those without detectable serum BKPyV-DNAemia were matched 1:1 by age and sex as controls. The primary endpoint was detection of BKPyV-DNAemia within 12 months post-KTX. Secondary endpoints included peak BKPyV-DNAemia and time to BKPyV-DNAemia onset.

Results

Among 438 KTX recipients, 216 (49.3%) received an UrSt. BKPyV-positive patients had higher rates of UrSt placement (51.6%) than BKPyV-negative patients (47.0%), though the difference was not statistically significant (p=0.339). BKPyV-DNAemia levels did not differ by UrSt duration (8 weeks; p=0.937), and peak BKPyV-DNAemia was comparable across groups, including patients without UrSt (p=0.983). No correlation was observed between UrSt duration and peak BKPyV-DNAemia (Spearman’s rho = -0.027; p=0.779). Time to BKPyV-DNAemia did not differ significantly across UrSt duration groups (p=0.361). In logistic regression, UrSt placement overall was not associated with BKPyV-DNAemia, but UrSt duration >8 weeks was a significant predictor in univariable and multivariable models [OR=1.744; (1.063–2.860); p=0.028)]. Neither UrSt presence nor duration predicted BKPyVAN.

Conclusion

This study could not confirm the association of BKPyV-DNAemia and UrSt placement. The previously described effect on BKPyV-DNAemia might be due to unknown confounders. UrSt duration >8 weeks, but not UrSt placement overall, appears to be a risk factor for BKPyV-DNAemia.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025drhfbb32