2025, Vol. 7, Issue 2, Part B

Background: BK polyomavirus (BKV) is a significant opportunistic pathogen in renal transplant recipients (RTRs), where its reactivation can lead to BK virus-associated nephropathy (BKVAN), a major cause of graft dysfunction and loss. Serum creatinine is a key biomarker for renal function and may serve as an indirect indicator of BKV-associated injury.

Objectives: This study aimed to investigate the relationship between serum creatinine levels and BK virus infection in renal transplant patients in Iraq.

Methods: A case-control study was conducted at Rizgary Teaching Hospital, Erbil, between October 2024 and January 2025, involving 105 renal transplant patients and 30 healthy controls. Blood samples were collected for serum creatinine measurement using a dry chemistry analyzer, and BKV DNA was detected in plasma by PCR targeting the large T antigen gene.

Results: Among 105 renal transplant patients, 7 (6.67%) tested positive for BKV. Serum creatinine levels were significantly elevated in BKV-positive patients compared with BKV-negative patients. The mean creatinine levels in BKV-positive patients were 2.1±0.5 mg/dL at Month 1, 2.5±0.8 mg/dL at Month 2, and 2.3±0.7 mg/dL at Month 3, indicating progressive graft dysfunction. In contrast, BKV-negative patients maintained normal creatinine levels (0.9±0.3 mg/dL).

Conclusion: The study demonstrated a strong association between BKV infection and elevated serum creatinine in renal transplant recipients in Iraq. Routine screening for BKV combined with creatinine monitoring may facilitate early detection of BKVAN, allowing timely intervention to preserve graft function. Larger multicenter studies are warranted to confirm these findings and establish standardized post-transplant monitoring protocols.