{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T08:29:43Z","timestamp":1765268983488},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>BK virus-associated nephropathy (BKVAN) exerts a substantial impact on allograft survival, however, the absence of robust clinical evidence regarding treatment protocols adds to the complexity of managing this condition. This study aimed to compare the two treatment approaches. The study population consisted of patients who underwent kidney transplantation between January 2016 and June 2020 at two tertiary hospitals in Korea. Patients diagnosed with BK viremia were evaluated based on their initial viral load and the treatment methods. The \u2018Reduction group\u2019 involved dose reduction of tacrolimus while the \u2018Conversion group\u2019 included tacrolimus discontinuation and conversion to sirolimus. A total of 175 patients with an initial viral load (iVL)\u2009\u2265\u20093 on the log10 scale were evaluated within two iVL intervals (3\u20134 and 4\u20135). In the iVL 4\u20135 interval, the Reduction group showed potential effectiveness in terms of viral clearance without statistically significant differences. However, within the iVL 3\u20134 interval, the Reduction group demonstrated superior viral clearance and a lower incidence of biopsy-proven acute rejection (BPAR) than the Conversion group. The renal function over 12\u00a0months after BKV diagnosis showed no statistically significant difference. Reducing tacrolimus compared to converting to mTORi would be a more appropriate treatment approach for BK viral clearance in kidney transplantation. Further research is warranted in a large cohort of patients.<\/jats:p>","DOI":"10.1038\/s41598-024-60695-2","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T17:05:38Z","timestamp":1717520738000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A comparative analysis of clinical outcomes between conversion to mTOR inhibitor and calcineurin inhibitor reduction in managing BK viremia among kidney transplant patients"],"prefix":"10.1038","volume":"14","author":[{"given":"Ara","family":"Cho","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunghae","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahram","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jongwon","family":"Ha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Berm","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyo Won","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sangil","family":"Min","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"60695_CR1","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/s1473-3099(03)00770-9","volume":"3","author":"HH Hirsch","year":"2003","unstructured":"Hirsch, H. H. & Steiger, J. Polyomavirus BK. Lancet Infect. Dis. 3, 611\u2013623. https:\/\/doi.org\/10.1016\/s1473-3099(03)00770-9 (2003).","journal-title":"Lancet Infect. Dis."},{"issue":"Suppl 2","key":"60695_CR2","doi-asserted-by":"publisher","first-page":"S68","DOI":"10.2215\/CJN.02770707","volume":"3","author":"A Dall","year":"2008","unstructured":"Dall, A. & Hariharan, S. BK virus nephritis after renal transplantation. Clin. J. Am. Soc. Nephrol. 3(Suppl 2), S68-75. https:\/\/doi.org\/10.2215\/CJN.02770707 (2008).","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"60695_CR3","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1097\/TP.0b013e31819cc383","volume":"87","author":"VR Dharnidharka","year":"2009","unstructured":"Dharnidharka, V. R., Cherikh, W. S. & Abbott, K. C. An OPTN analysis of national registry data on treatment of BK virus allograft nephropathy in the United States. Transplantation 87, 1019\u20131026. https:\/\/doi.org\/10.1097\/TP.0b013e31819cc383 (2009).","journal-title":"Transplantation"},{"key":"60695_CR4","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1016\/s0140-6736(71)91776-4","volume":"1","author":"SD Gardner","year":"1971","unstructured":"Gardner, S. D., Field, A. M., Coleman, D. V. & Hulme, B. New human papovavirus (B.K). isolated from urine after renal transplantation. Lancet 1, 1253\u20131257. https:\/\/doi.org\/10.1016\/s0140-6736(71)91776-4 (1971).","journal-title":"Lancet"},{"key":"60695_CR5","doi-asserted-by":"publisher","DOI":"10.3390\/v13030487","author":"CL Shen","year":"2021","unstructured":"Shen, C. L., Wu, B. S., Lien, T. J., Yang, A. H. & Yang, C. Y. BK polyomavirus nephropathy in kidney transplantation: Balancing rejection and infection. Viruses https:\/\/doi.org\/10.3390\/v13030487 (2021).","journal-title":"Viruses"},{"key":"60695_CR6","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1056\/NEJMe020076","volume":"347","author":"JA Fishman","year":"2002","unstructured":"Fishman, J. A. BK virus nephropathy\u2013polyomavirus adding insult to injury. N. Engl. J. Med. 347, 527\u2013530. https:\/\/doi.org\/10.1056\/NEJMe020076 (2002).","journal-title":"N. Engl. J. Med."},{"key":"60695_CR7","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13528","volume":"33","author":"HH Hirsch","year":"2019","unstructured":"Hirsch, H. H., Randhawa, P. S., Practice, A. S. T. I. D. C. o. BK polyomavirus in solid organ transplantation-guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin. Transplant. 33, e13528. https:\/\/doi.org\/10.1111\/ctr.13528 (2019).","journal-title":"Clin. 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