Maintenance immunosuppressive agents as risk factors for BK virus nephropathy: the need for true drug exposure measurements.

摘要

We have read with interest the article by Manitpisitkul et al. (I). In this case-control retrospective study, the authors observed a significant association between tacrolimus 12-hr trough concentrations and prednisone daily doses during the preceding 3 months and the subsequent histologic diagnosis of BK virus nephropathy (BKN), whereas no association was found with mycophenolate mofetil (MMF) dose. The authors concluded from their data that instead of the current clinical approach in cases of BKN with drastic reduction or stopping of MMF and further reduction in calcineurin inhibitor, it may be more appropriate to maintain MMF dose and reduce tacrolimus levels more aggressively together with the prednisone dose.