Risk factors for BK virus viremia and nephropathy after kidney transplantation: A systematic review.Demey B, Tinez C, et al.
J Clin Virol. 2018; 109:6-12.
To carry out a systematic review of risk factors for BKPyV viremia and nephropathy in kidney transplant patients on the basis of multivariate analyses.
The PubMed database was searched for prospective or prospectively-based observational studies on risk factors for BKPyV viremia and/or nephropathy. A risk factor for BKPyV infection was defined as a preoperative, pre- or post-transplantation patient-related factor that is thought to increase the risk of onset of BKPyV viremia and/or nephropathy. The qualitative assessment of risk factors was based on the ORs and HRs calculated in multivariate regression analyses.
34 prospective cohort studies and studies based on prospectively recorded databases were reviewed. 13135 patients were evaluated, and 1923 of these (14.6%) presented BKPyV viremia. Six studies featured a multivariate analysis of risk factors for BKPyVN neuropathy; a total of 2821 patients had been evaluated, and 149 of these presented BKPyVN neuropathy (5.3%).
144 distinct factors had been analyzed statistically for BKPyV viremia and 19 distinct factors for BKPyV nephropathy.
PubMed database was searched on September 30th, 2017; there was no restriction on publication date.
The systematic review aimed to identify preoperative, pre-transplantation and post-transplantation risk factors for BK polyomavirus viremia and nephropathy in kidney transplant recipients. PubMed was searched, limited to the English literature. Study eligibility was determined by two reviewers. The methodological quality of articles was not assessed and there was no description of how the data extraction was done. Risk factors for BK polyomavirus viremia were defined as those tested in at least two multivariate analyses and found statistically significant in at least one multivariate analysis. Risk factors for BK polyomavirus nephropathy were those found significant in one multivariate analysis. Thirty-four prospective cohort studies and studies based on prospectively recorded databases were included, analysing a total of 144 risk factors for BK polyomavirus viremia and 19 risk factors for BK polyomavirus nephropathy. The authors highlighted eight risk factors considered to be most relevant for BK polyomavirus viremia and two risk factors for BK polyomavirus nephropathy.
Quality assessment not appropriate