Intermediate-dose XXXX without probenecid in the treatment of @entity8999 allograft @entity8 .

@entity1 @entity8 @entity646 @entity8999 @entity7076 @entity1011
@entity8999 allograft @entity8 (BKVAN) is a rising complication in kidney transplant recipients. Reducing immunosuppression has been the initial form of therapy in most cases, but is not always associated with improvement in graft function. Anti-viral therapy with low-dose @entity7076 (0.25-0.42 mg/kg/dose) has been used successfully in some @entity1 , but dose-related nephrotoxicity has limited its use. We present our experience with 3 kidney transplant recipients diagnosed with BKVAN who received intermediate-dose @entity7076 (0.75-1.0 mg/kg/dose) without probenecid, and without concomitant nephrotoxicity. Three female @entity1 , ages 8, 19 and 20 yr, presented with elevated serum @entity1011 (SCr) values, @entity8999 stain positive on renal biopsy and high plasma BK viral loads. As a result of viral loads being >2 million copies/ml in two @entity1 and a lack of response to reduction in immunosuppression in the third, we initiated therapy with low-dose @entity7076 . Because of persistent positive BK stain and positive plasma viral load, we then administered intermediate-dose @entity7076 , without probenecid, for several subsequent doses (seven to 15 infusions till date). All @entity1 tolerated the intermediate-dose @entity7076 with no significant rise in SCr during the course of the infusions. The most recent SCr values in all three @entity1 were improved from those at the initial diagnosis of BKVAN. All three @entity1 showed a marked drop in BK viral loads when on intermediate-dose @entity7076 , with complete clearing of @entity646 in two @entity1 . In our experience, intermediate-dose @entity7076 without probenecid, used judiciously, is not associated with additional nephrotoxicity and may provide an additional alternative for treatment.
