Frontiers in nephrology最新文献

{"title":"Safety and efficacy of rituximab-free ABO incompatible kidney transplantation: a German multicenter cohort study.","authors":"Ulrich Pein, Klemens Budde, Lutz Liefeldt, Anja Gäckler, Rolf Weimer, Hristos Karakizlis, Claudia Sommerer, Louise Benning, Christine Kurschat, Dirk Stippel, Ana Harth, Julia Weinmann-Menke, Martina Koch, Birgit Kortus-Goetze, Stefan Reuter, Nils Lachmann, Anja Mühlfeld","doi":"10.3389/fneph.2026.1899385","DOIUrl":"10.3389/fneph.2026.1899385","url":null,"abstract":"<p><strong>Background: </strong>ABO-incompatible living kidney transplantation (ABOi-LKT) has become an established procedure with long-term patient and graft survival comparable to ABO-compatible transplantation. However, intensified immunosuppression increases the risk of severe infectious complications, particularly in the early post-transplant period. This study investigated whether ABOi-LKT in patients with low baseline anti-ABO isoagglutinin titers can be performed safely without rituximab and thereby reduce infectious complications.</p><p><strong>Methods: </strong>In this multicenter retrospective cohort study, recipients of ABOi-LKT with low pretransplant anti-ABO titers (≤1:16) were compared according to rituximab use. Clinical outcomes, graft function, rejection episodes, surgical complications, and infectious events were analyzed.</p><p><strong>Results: </strong>Eleven German transplant centers identified 46 patients who underwent ABOi-LKT without rituximab between 2016 and 2024 and 85 low-titer recipients who received rituximab (single dose 375 mg/m²). Baseline characteristics and median pretransplant anti-ABO titers (1:2) were comparable between groups. Patients underwent a median of two extracorporeal antibody eliminations and received comparable immunosuppression. Graft function at discharge and after 3 and 12 months, as well as proteinuria, did not differ between cohorts. One graft loss due to acute antibody-mediated rejection occurred in the rituximab-free group, whereas two graft losses (one rejection, one BK polyomavirus nephropathy) and one patient death occurred in the rituximab group. Rates of surgical complications (34.8% vs. 36.5%), blood transfusions (21.7% vs. 17.6%), and rejection episodes (15% vs. 20%; p=0.499) were similar. In contrast, infectious complications were significantly more frequent among rituximab-treated patients, with a 2.4-fold increased infection risk (p=0.018). Infection-related hospitalizations occurred significantly more often in the rituximab group (64.6% vs. 31.3%; p=0.003).</p><p><strong>Conclusions: </strong>ABOi-LKT without rituximab appears safe in recipients with low pretransplant anti-ABO titers. Short-term graft function, graft survival, patient survival, and immunological outcomes were comparable to rituximab-based desensitization. Importantly, omission of rituximab was associated with significantly fewer infectious complications and infection-related hospitalizations, supporting a tailored, lower-intensity immunosuppressive approach in selected low-risk patients.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1899385"},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A four-parameter laboratory risk stratification model at admission for 90-day mortality in hepatorenal syndrome-acute kidney injury: a single-center derivation and internal validation study.","authors":"Julian Müller-Kühnle, Mathias Becker, Severin Schricker, Wolfram Zoller, Jörg Latus, Moritz Schanz","doi":"10.3389/fneph.2026.1796660","DOIUrl":"10.3389/fneph.2026.1796660","url":null,"abstract":"<p><strong>Background: </strong>Hepatorenal syndrome-acute kidney injury (HRS-AKI) is a high-mortality complication of advanced cirrhosis. Early risk stratification after hospital admission may support clinical assessment and research on escalation pathways, but simple admission-based models that avoid in-hospital data leakage remain limited.</p><p><strong>Methods: </strong>We performed a retrospective single-center derivation and internal-validation study of hospitalized adults with chart-review-confirmed HRS-AKI according to contemporary ADQI/ICA criteria. Candidate predictors were restricted <i>a priori</i> to admission laboratory values to minimize data leakage. Admission variables were prioritized using random-forest importance rankings under prespecified parsimony constraints, followed by endpoint-specific closed-form logistic regression models using an identical four-predictor set across outcomes. The primary endpoint was 90-day all-cause mortality. In-hospital hemodialysis and ICU admission were prespecified secondary endpoints and are reported as exploratory. Internal validation used bootstrap resampling with assessment of apparent and optimism-corrected discrimination and overall accuracy; calibration slope and calibration-in-the-large/intercept were reported descriptively. For contextual benchmarking, admission MELD, MELD-Na, and MELD 3.0 were evaluated as single-predictor logistic benchmark models for 90-day mortality within the same cohort.</p><p><strong>Results: </strong>The final analysis included 77 patients. The final predictor set comprised INR, albumin, ln(total bilirubin), and ln(C-reactive protein). For 90-day mortality, the final four-laboratory model showed an apparent AUC of 0.781 (95% CI, 0.715-0.926) and an optimism-corrected AUC of 0.758 (95% CI, 0.648-0.859), with an apparent Brier score of 0.144 (95% CI, 0.081-0.176), an optimism-corrected Brier score of 0.168 (95% CI, 0.117-0.212), an optimism-corrected calibration slope of 0.770, and an optimism-corrected calibration-in-the-large/intercept of 0.168. Performance for in-hospital hemodialysis and ICU admission was limited, with optimism-corrected AUCs of 0.580 (95% CI, 0.451-0.733) and 0.631 (95% CI, 0.514-0.737), respectively. MELD-family benchmarks showed numerically lower within-cohort discrimination than the four-laboratory model; these comparisons were descriptive and hypothesis-generating.</p><p><strong>Conclusions: </strong>In this single-center derivation and internal-validation study, an admission-based four-laboratory model showed moderate internally validated discrimination for 90-day mortality in hospitalized patients with HRS-AKI. The model should be interpreted as a preliminary risk-stratification approach requiring external validation and, if necessary, recalibration before clinical use. Secondary endpoint models for hemodialysis and ICU admission are exploratory and should not be used for threshold-based decision-making.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1796660"},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial transcriptomic analysis of kidney biopsies identifies activation of complement and SPP1 networks in <i>Staphylococcus</i> infection-associated glomerulonephritis.","authors":"Spyros Karaiskos, Luis Santana-Quintero, Cherri Bott, Rahul Paul, Sergey V Brodsky, Isabelle Ayoub, Samir V Parikh, Brad H Rovin, Tibor Nadasdy, Hira L Nakhasi, Sreenivas Gannavaram, Anjali A Satoskar","doi":"10.3389/fneph.2026.1863912","DOIUrl":"10.3389/fneph.2026.1863912","url":null,"abstract":"<p><strong>Background: </strong><i>Staphylococcus</i> infection-associated glomerulonephritis (SAGN) has emerged as the leading cause of infection-related glomerulonephritis (IRGN) in the Western subcontinents, but pathogenesis remains poorly understood in the absence of animal models and detailed molecular mechanisms.</p><p><strong>Methods: </strong>To dissect the complex underlying immunopathology, we analyzed formalin-fixed paraffin-embedded kidney biopsy tissues from three patients with SAGN and one normal control kidney (NCK) using single-cell spatial transcriptomics (analyzing a total of 3,993 cell-specific transcriptomes). The SAGN biopsies showed diffuse endocapillary hypercellularity with focal crescents. Following annotation of various cell types, we constructed cell communication networks using CellChat to identify ligand-receptor interactions in normal and SAGN kidneys.</p><p><strong>Results: </strong>Secreted phosphoprotein 1 (SPP1/osteopontin) emerged as the most enriched signaling network in SAGN with markedly increased autocrine and paracrine SPP1-CD44 activity among tubular segments and parietal epithelial cells (PECs). In contrast, SPP1-integrin signaling was mainly observed in healthy control kidneys. Consistent with previous reports, complement pathway activation was detected exclusively in diseased kidneys, with PECs as principal signal receivers, suggesting the potential role in crescent formation. Transcripts for C2, C3, CD55, Factor B, and Factor D showed significant upregulation in SAGN. In contrast, vascular endothelial growth factor (VEGF), angiopoietin-like proteins (ANG PTL), and progranulin/granulin networks exhibited decreased communication probabilities in SAGN versus NCK, suggesting the suppression of protective angiogenic and anti-inflammatory signaling. Immunofluorescence staining for SPP1 showed increased staining in renal tubular segments in SAGN biopsies, supporting our transcriptomic data.</p><p><strong>Conclusion: </strong>SPP1 and complement pathways appear to drive pro-inflammatory responses, while protective VEGF signaling is compromised, providing potential therapeutic targets for this disease.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1863912"},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of vitamin D supplementation in diabetic kidney disease: an umbrella review of systematic reviews and meta-analyses.","authors":"Víctor Juan Vera-Ponce, Jhosmer Ballena-Caicedo","doi":"10.3389/fneph.2026.1883351","DOIUrl":"10.3389/fneph.2026.1883351","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD), including classical diabetic nephropathy, is a leading cause of chronic kidney disease and kidney replacement therapy. Vitamin D supplementation has been proposed to reduce albuminuria, but the available reviews are heterogeneous and redundant.</p><p><strong>Objective: </strong>To critically evaluate and summarize the efficacy and safety of native vitamin D and active vitamin D analogs in adults with DKD, including studies reported as diabetic nephropathy (DN).</p><p><strong>Methods: </strong>An overview of reviews registered in PROSPERO (CRD420251250914). Systematic reviews, with or without meta-analysis, were searched in MEDLINE/PubMed, Embase, the Cochrane Library, Web of Science, and Scopus, without language restrictions, through April 2, 2026. Methodological quality was assessed with AMSTAR-2, risk of bias with ROBIS, overlap with Corrected Covered Area (CCA), and certainty of evidence with GRADE. The synthesis used one anchor review per outcome, without <i>de novo</i> quantitative reanalysis.</p><p><strong>Results: </strong>Eleven reviews met the eligibility criteria; nine provided evidence derived from randomized trials or separable randomized-trial data, and two were retained as contextual evidence. GRADE certainty was low for the surrogate urinary outcomes UACR and UAER, low to very low for 24-hour proteinuria, and very low or not evaluable for renal function, kidney replacement therapy, mortality, cardiovascular events, safety, and metabolic-inflammatory outcomes. Overlap was high (overall CCA, 13.5%; RCT-derived corpus, 14.1%). The evidence was compatible with low-certainty reductions in surrogate urinary outcomes, especially UACR and UAER, without consistent benefit for eGFR, serum creatinine, kidney replacement therapy, mortality, or cardiovascular events; safety was insufficiently reported.</p><p><strong>Conclusions: </strong>Vitamin D shows a low-certainty reduction in surrogate urinary markers of albuminuria/proteinuria in DKD, but current evidence is insufficient to support vitamin D as a specific renoprotective intervention beyond conventional indications for deficiency or mineral and bone disorders.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251250914, identifier CRD420251250914.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1883351"},"PeriodicalIF":2.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13414108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Renal sarcoidosis coexisting with membranous and IgA nephropathy, a very uncommon association.","authors":"Mariel Hernández-Pérez, Daniel Enos, Rocío Contreras Faundez, Joaquín Ramírez Herrera, Pablo Tapia Riedemann, Gonzalo P Méndez, Jorge Gutiérrez Ventura","doi":"10.3389/fneph.2026.1809424","DOIUrl":"10.3389/fneph.2026.1809424","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcoidosis is a multisystemic inflammatory disease of unknown etiology with more frequent lung and lymph node involvement. Despite kidney involvement occurring between 25% and 43%, it may be underdiagnosed, with interstitial granulomatous nephritis and nephrocalcinosis being the most common features, and glomerular disease being less frequent.</p><p><strong>Case report: </strong>A 43-year-old man came to the emergency room (ER) because of macroscopic hematuria, arthralgias, pitting inferior extremities edema, asthenia, and dry cough without dyspnea. Evaluation revealed nephrotic range proteinuria and glomerular hematuria, suggesting an impure nephrotic syndrome. The kidney biopsy showed features of membranous nephropathy and granulomatous interstitial nephritis, with immunofluorescence showing codominant mesangial immunoglobulin A (IgA) and immunoglobulin G (IgG) deposits.</p><p><strong>Management and outcome: </strong>Steroids plus angiotensin receptor blocker (ARB) antagonists were effective, with symptoms subsiding and proteinuria level decreasing after 8 months of follow-up.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1809424"},"PeriodicalIF":2.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Intradialytic blood pressure instability and associated factors among hemodialysis patients in Somalia: a retrospective study.","authors":"Abdulrashid Hashi Mohamed, Mohamud Mire Waberi, Feyza Aksu, Nurto Abdulkadir Said, Said Abdirahman Ahmed","doi":"10.3389/fneph.2026.1921166","DOIUrl":"https://doi.org/10.3389/fneph.2026.1921166","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fneph.2026.1822440.].</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1921166"},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Effect of preexisting human leukocyte antigen donor-specific antibodies especially human leukocyte antigen-DQ on kidney transplant outcome.","authors":"Sonia Mehrotra, Raj Kumar Sharma, Rakesh Kapoor, Rajesh Kumar Jaiswal, Rohit Kapoor","doi":"10.3389/fneph.2026.1864478","DOIUrl":"https://doi.org/10.3389/fneph.2026.1864478","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fneph.2026.1734903.].</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1864478"},"PeriodicalIF":2.9,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma proteomics based on machine learning predict the early risk of kidney outcomes in patients with DKD: a prospective cohort study from UK Biobank.","authors":"Li Jiang, Tingting Li, Haojun Zhang, Xiai Wu, Tingting Zhao","doi":"10.3389/fneph.2026.1862772","DOIUrl":"10.3389/fneph.2026.1862772","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD) is the predominant cause of end-stage kidney disease worldwide. Early identification of patients at heightened risk for adverse kidney outcomes remains a critical unmet clinical need.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of 918 DKD participants from the UK Biobank. Baseline plasma proteomic profiling quantified 1,463 proteins using Olink proximity extension assays. Three nested Cox proportional hazards models with incremental covariate adjustment identified proteins associated with composite kidney outcomes. To prevent information leakage, all feature selection, hyperparameter optimization, and model development were performed exclusively within the training cohort (70% random split) via a multi-stage pipeline integrating LASSO-Cox regression, Random Survival Forest, Boruta algorithm, and Sequential Forward Selection. XGBoost Cox modeling with SHAP interpretability analysis quantified variable contributions. Predictive performance was validated through Kaplan-Meier survival analysis, 15-year longitudinal trajectory modeling, ROC benchmarking, 10-fold nested cross-validation, and sensitivity analyses restricted to KDIGO-defined DKD. An interactive web application was developed for clinical translation.</p><p><strong>Results: </strong>Of 1,463 proteins examined, 633 demonstrated significant associations with kidney outcomes across all three Cox models. Functional enrichment highlighted immune-inflammatory pathways, PI3K-Akt signaling, and chemokine cascades as central to DKD progression. The machine learning framework identified an 11-protein signature, which was refined to 10 core biomarkers (HLA-E, EFNA1, GPR158, FSTL3, ART3, GM2A, CLEC1A, CKAP4, IFNGR1, EPHA2) following survival and longitudinal trajectory validation. The protein-only model achieved robust discrimination (AUC = 0.808 [95% CI 0.767-0.848] for composite outcomes; AUC = 0.807 [95% CI 0.765-0.848] for renal death), comparable to fully integrated models incorporating demographics and metabolic variables. Systematic benchmarking across 101 algorithm combinations identified LASSO-RSF as optimal (C-index = 0.94 in training; 0.73 in independent testing), with reliable calibration through mid-term follow-up (Integrated Calibration Index = 0.019-0.022). The web-based tool enables real-time, personalized risk stratification.</p><p><strong>Conclusions: </strong>This study establishes a validated 10-protein signature for early prediction of kidney outcomes in DKD. The systematic machine learning framework and deployable web application provide accessible, interpretable risk assessment to support precision nephrology and preemptive clinical intervention.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1862772"},"PeriodicalIF":2.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of valganciclovir dosing following kidney transplantation and its impact on clinical outcomes.","authors":"Jessica Forsyth, David Randall, Raj Thuraisingham","doi":"10.3389/fneph.2026.1781576","DOIUrl":"10.3389/fneph.2026.1781576","url":null,"abstract":"<p><p>Valganciclovir is widely used as prophylaxis against cytomegalovirus (CMV) infection following solid organ transplantation. However, valganciclovir requires dose adjustment based on kidney function. This retrospective observational study at a London kidney transplant center explored the accuracy of valganciclovir dosing in the first 3 months following transplantation and its impact on clinical outcomes. Data for adult kidney transplant recipients (KTRs) receiving valgancivloir prophylaxis between 2017 to 2019 was analyzed. The primary outcome was the difference between the prescribed and optimum valganciclovir dose (calculated by creatinine clearance) on days 10-92 after surgery. Secondary outcomes included associations between valganciclovir dosing with CMV DNAemia, cytopenias and rejection. For the 90 KTRs included, the valganciclovir dose was optimum for 51%, underdosed for 31% and overdosed for 18% of the study period. Significant associations were shown for underdosing and CMV DNAemia (B = 2.88, SE = 1.14, p=0.01, 95% CI [1.90,166.1]) as well as overdosing and neutropenia (B = 2.29, SE 0.99, p=0.02, 95% CI [1.42,68.71]). This study highlights the difficulty in optimally dosing valganciclovir in KTRs post-operatively and importantly shows significant associations between suboptimal dosing and clinical outcomes.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1781576"},"PeriodicalIF":2.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No association between delayed graft function and BK polyomavirus infection reactivation after kidney transplantation: a systematic review and meta-analysis.","authors":"Thidarat Kitrungphaiboon, Felicity Evison, Suzy Gallier, Adnan Sharif","doi":"10.3389/fneph.2026.1790723","DOIUrl":"10.3389/fneph.2026.1790723","url":null,"abstract":"<p><strong>Introduction: </strong>An association between delayed graft function (DGF) and BK polyomavirus (BKPyV) DNAemia is not well defined.</p><p><strong>Methods: </strong>We investigated this with 1) a retrospective review of a single-center cohort analysis, and 2) a systematic review & meta-analysis of published data. Kidney transplant recipients at a single-center between 01/01/2007-30/06/2018 were analyzed. Comparative analyses were done with logistic regression models based upon clinical risk factors. Following a systematic review of published studies, meta-analysis was performed using the DerSimonian-Laird random effects model.</p><p><strong>Results: </strong>In our single-center analysis, we analyzed 1,770 kidney transplant recipients with median follow up 5.3 years (interquartile range 2.7-8.7 years). BKPyVDNAemia was associated with; male sex (8.3% versus 5.3% respectively, p=0.017), ABO-incompatible transplantation (10.3% versus 4.6% respectively, p=0.004) and DGF (9.0% versus 6.3% respectively, p=0.048). In a multivariate analysis, only recipient male sex and ABO-incompatible transplantation was associated with BKPyVDNAemia. In a systematic review of published literature, we identified 11 studies and performed a meta-analysis of empirical data including our Birmingham cohort data. No significant association was observed between DGF rates and BKPyVDNAemia (OR 1.00, 95% CI 0.67-1.50).</p><p><strong>Discussion: </strong>We did not identify any association between DGF rates and subsequent BKPyVDNAemia.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1790723"},"PeriodicalIF":2.9,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}