{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:09:44Z","timestamp":1787314184165,"version":"build-2736575974"},"reference-count":79,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T00:00:00Z","timestamp":1736553600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["223495\/Z\/21\/Z"],"award-info":[{"award-number":["223495\/Z\/21\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["MR\/X030997\/1"],"award-info":[{"award-number":["MR\/X030997\/1"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000291","name":"Kidney Research UK","doi-asserted-by":"publisher","award":["RP_018_20220706"],"award-info":[{"award-number":["RP_018_20220706"]}],"id":[{"id":"10.13039\/501100000291","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>BK polyomavirus (BKPyV) is recognized as a significant viral complication of kidney transplantation. Prompt immunosuppression reduction reduces early graft failure rates due to BK polyomavirus-associated nephropathy (BKPyVAN), however, modulation of immunosuppression can lead to acute rejection. Medium-to-long-term graft outcomes are negatively affected by BKPyVAN, probably due to a combination of virus-induced graft damage and host immune responses against graft alloantigens potentiated by immunosuppression reduction. Kidney biopsy remains the gold-standard diagnostic test, however, false-negative findings are common due to the focal nature of BKPyVAN. BKPyV DNAemia, as measured by quantitative polymerase chain reaction, is established as a screening test but there is at present no (inter)national standardization of these assays to allow collation and comparison of data between centres. Randomized controlled trials are lacking both in terms of optimal immunosuppression reduction strategies, and for the medications variably used to attempt treatment in clinical practice. Much of the fundamental biology of BKPyV is not yet understood, and further elucidation is required to promote rational direct-acting antiviral drug design. Insights into the role of adaptive immunity in control of BKPyV have informed the design of novel treatments such as adoptive immunotherapies and neutralizing antibodies that require evaluation in clinical studies. Here, we review the current standards of diagnosis and treatment of BKPyVAN and discuss novel developments in the pathophysiology, diagnosis, outcome prediction, and management.<\/jats:p>","DOI":"10.1093\/ndt\/gfaf002","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T15:19:50Z","timestamp":1736435990000},"page":"651-661","source":"Crossref","is-referenced-by-count":15,"title":["BK Polyomavirus-associated nephropathy \u2013 diagnostic and treatment standard"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1490-7036","authenticated-orcid":false,"given":"Mohammed","family":"Al-Talib","sequence":"first","affiliation":[{"name":"Systems Immunity Research Institute, Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff ,","place":["UK"]},{"name":"Bristol Medical School, University of Bristol , 5 Tyndall Avenue, Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Welberry-Smith","sequence":"additional","affiliation":[{"name":"Faculty of Biological Sciences, University of Leeds , Woodhouse, Leeds ,","place":["UK"]},{"name":"Department of Renal Medicine and Transplantation, Leeds Teaching Hospitals NHS Trust , Beckett Street, Leeds ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Faculty of Biological Sciences, University of Leeds , Woodhouse, Leeds ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si\u00e2n","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, Cardiff and Vale University Health Board , Cardiff 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