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New Urine
Test Detects Common Cause of Kidney
Transplant Failure
Newswise — A new and simple urine test can detect
polyomavirus nephropathy, a relatively new
and serious complication that affects up to
9% of kidney transplant recipients,
according to a study appearing in the
February 2009 issue of the Journal of the
American Society Nephrology (JASN).
The advance could lead to better diagnosis and treatment of
patients with this condition.
While polyomaviruses are normally occurring viruses that
harmlessly infect many adults, they can pose
serious health problems for individuals who
become immunocompromised.
Such is the case for many kidney transplant recipients who
must take immunosuppressive medications to
safeguard against organ rejection.
Some of these patients develop a damaging condition called
polyomavirus nephropathy that can lead to
chronic kidney failure and the need to
re-initiate dialysis or undergo another
transplant.
Because there are no effective therapies to treat
polyomavirus nephropathy, it is important to
diagnose the condition as early as possible,
before it becomes serious.
Therapy normally consists of lowering the dose of
immunosuppressive drugs and hoping for
natural viral clearance.
Unfortunately, there currently is no definitive way to
accurately diagnose polyomavirus
nephropathy.
Physicians rely mostly on invasive and expensive kidney
biopsies, which sometimes give false
negative results. But now Volker Nickeleit,
MD, of the University of North Carolina in
Chapel Hill, North Carolina and his
colleagues have discovered a new and
noninvasive way to test for the condition.
The test measures “Haufen”—a German term meaning stack or
pile—in the urine. Haufen are tightly
clustered viral aggregates that form within
the kidneys in patients with polyomavirus
nephropathy and are excreted in the urine.
Testing for Haufen is fast (three hours),
inexpensive (less than $400), and easy to
perform with current laboratory equipment.
Through their investigation, the researchers found Haufen
in urine samples from all 21 patients with
early or late stages of polyomavirus
nephropathy, but not in any of the 139
individuals without the condition.
According to Dr. Nickeleit, the new test could help
physicians identify and monitor patients
with polyomavirus nephropathy and could
guide them as they design new therapeutic
strategies.
“An early and accurate diagnosis of polyomavirus
nephropathy will result in a better
understanding of the disease and ultimately
improve treatment,” he said.
“Our diagnostic test is unique and could have a tremendous
clinical impact,” he added.
While their findings look promising, the authors stress
that additional studies—particularly large
prospective clinical trials—are needed to
verify the test’s potential before it can
become available for widespread use in
patients with suspected polyomavirus
nephropathy.
The article, entitled “A New Urinary Biomarker to
Accurately Predict Polyomavirus
Nephropathy,” will appear online at
http://jasn.asnjournals.org/ on January
21, 2009, and in the February 2009 print
issue of JASN.
ASN is a not-for-profit organization of 11,000 physicians
and scientists dedicated to the study of
nephrology and committed to providing a
forum for the promulgation of information
regarding the latest research and clinical
findings on kidney diseases.
ASN publishes the JASN, the Clinical Journal of the
American Society of Nephrology (CJASN), the
Nephrology Self-Assessment Program (NephSAP),
and ASN Kidney News.
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