#IDTwitter #IDXposts What is the significance of ➕ CMV PCR (4481 IU/mL) in urine, but ➖ in blood in patient w/ transplanted kidney 4 years ago, last 2 years with BK nephropathy with 🔺 BK viral load both in urine & blood, and moderatelly impared kidney function? @transplantID
@BJegorovic @transplantID Question is why was it done in 1st place 🤔
@BJegorovic Definitely have never checked cmv in urine . But if graft not functioning well w bk in blood- def biopsy , decr immunosuppression. Is cmv + in blood ? Could just have 2 separate issues , bk nephropathy and cmv viremia (treat according to level , cmv status d-/r+ etc )
@BJegorovic @transplantID I have not seen urine CMV measured outside of pediatrics. CMV nephritis can happen though not it is common. Classically GI and ocular disease are compartmentalized but this could also apply to the kidneys. Regardless, if concerns with the graft, biopsy. And ⬇️ immunosuppression.
@BJegorovic @transplantID Don’t know cmv in urine significance but if worsening graft function would biopsy. If bk level currently elevated would treat that
@BJegorovic @transplantID I don’t think there is a role for CMV quantification in urine in adult SOT patients.