Urological manifestations of BK polyomavirus in renal transplant recipients.
Bibliographic record
Abstract
OBJECTIVES: BK polyomavirus (BKV) disease in renal transplant recipients has become an increasingly problematic clinical entity. Complications of BKV disease lead to chronic allograft nephropathy and ultimately loss in greater than 50% of cases. We reviewed our experience with BKV disease over a 5-year period. PATIENTS AND METHODS: We performed 155 cadaveric and 168 live-related transplants between January 2000 and June 2005. During this period, seven patients had biopsy-confirmed BKV disease, which compromised the renal function of six cadaveric and one live-related renal transplant recipients. BKV was suspected as a potential cause of renal function deterioration after eliminating other possibilities. BKV was then confirmed by detecting viral DNA in urine samples by polymerase chain reaction (PCR) and visualizing viral particles in allograft biopsies by electron microscopy. RESULTS: The deterioration of allograft function in five renal transplant recipients was due to polyomavirus-associated nephropathy and two due to ureteric stenosis. Upon confirmation of BKV, overall immunosuppression was reduced or modified with follow-up of 5 to 44 months. However, additional rescue therapies were used to stabilize allograft function including ciprofloxacin, intravenous immunoglobulin, and leflunomide. One patient died and another lost his allograft due to non-compliance and reverted to hemodialysis, but renal function in the remaining five allografts has remained stable at higher serum creatinine levels. CONCLUSIONS: The management of BKV disease in renal transplant recipients is not yet clearly defined. However, early recognition of urological sequelae and modification of immunosuppressive therapy are essential to ensure adequate long-term function of these allografts.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".