Risk factors for BK viremia in kidney transplantation recipients: A meta-analysis

Objective To assess the risk factors for BKV viremia in kidney transplantation recipients by meta-analysis. Methods Papers and their references on the risk factors for BKV viremia in kidney transplantation recipients published from January 2000 to August 2013 were retrieved from CAJD, CBM, PubMed and Foreign Medical Journal Full-Text Database. Cohort and case control studies were assessed according to the quality assessment methodology suggested in the references. Randomized control trials (RCT) were assessed following the Jadad scale. Heterogeneity of RCT was tested using Software Stata 11.0. The risk ratio (RR) and its 95%CI were calculated according to the fixed or random effect model. Results Sixteen papers (925 cases of BKV viremia following kidney transplantation) were included in the meta-analysis. Advanced age 1.032(1.017-1.047), P=0.000, long cold ischemia1.737(1.191-2.535), P=0.004, ≥4 mismatched HLA1.303(1.103-1.540), P=0.002, immune induction using ATG1.230 (1.041-1.453), P=0.015, DGF1.57(1.08-2.29), P=0.018, acute rejection 3.672(2.106-6.402), P=0.000, immune maintenance therapy with FK506+MMF1.632(1.329-2.005), P=0.000, and CMV infection2.182(1.286-3.700), P=0.004 were the risk factors for BK viremia. The risk was greater to develop BK viremia in patients with multiple risk factors than in those with a single risk factor. Conclusion Advanced age, long cold ischemia, ≥4 mismatched HLA, immune induction using ATG, DGF, acute rejection, immune maintenance therapy with FK506+MMF, and CMV infection are the risk factors for BK viremia in kidney transplantation recipients