Análisis citológico para la evaluación urinaria en pacientes trasplantados renales con infección del virus BK
- Pérez Rojas, Judith
- Rubio, Luis
- Artes Martínez, María José
- Prieto Rodríguez, M.
- Vera Sempere, Francisco José
ISSN: 1886-2845
Year of publication: 2014
Volume: 35
Issue: 1
Pages: 7-14
Type: Article
More publications in: Diálisis y trasplante: publicación oficial de la Sociedad Española de Diálisis y Trasplante
Abstract
Introduction Tubulointerstitial nephritis associated with the BK virus is a complication of kidney transplantation. Markers of BK virus replication include the presence of viral inclusions called «Decoy cells» in urine cytology and high titers of ADN viral load in plasma, urine, and renal tissue. Objective To evaluate the diagnostic utility of urine cytology for the early identification of BK virus infection by using 3 different types of cytological screening. Results Urinary cytology as a diagnostic test showed high sensitivity (81.4%) in identifying renal transplant recipients with BK virus infection. Specificity was only 22.6%. The 3 methods of urine cytology screening appeared to have similar effectiveness in quantifying cell density. Conclusions Urine cytology is a reliable test for the detection of Decoy cells but is not diagnostic. Irrespective of the screening method used, detection of Decoy cells may be an indirect and sensitive method for estimating the existence of BK viral replication, although urinary polymerase chain reaction and kidney biopsy have greater specificity in the diagnosis of BK virus nephritis.