Retransplantation after kidney graft loss due to polyoma BK virus nephropathy: successful outcome without original allograft nephrectomy.

Although polyoma BK virus (BKV)-associated interstitial nephritis has received increasing attention because of its clinical relevance in kidney allograft recipients, data on risk for repeated renal transplantation after BKV-related allograft loss are limited, and the need to perform an original graft nephrectomy is the object of debate. A 15-year-old boy with renal failure secondary to Alport's syndrome underwent renal transplantation. His posttransplantation course was complicated by acute rejection episodes and the presence of circulating anti-glomerular basement membrane antibodies that required aggressive immunosuppressive treatment.

Acute effects of peritoneal dialysis with dialysates containing dextrose or dextrose and amino acids on muscle protein turnover in patients with chronic renal failure.

Whether changes in substrate and insulin levels that occur during peritoneal dialysis (PD) have effects on muscle protein dynamics was evaluated by studying muscle protein synthesis (PS), breakdown (PB), and net protein balance (NB) by the forearm perfusion method associated with the kinetics of 3H-phenylalanine in acute, crossover studies in which PD patients served as their own controls. Studies were performed (1) in the basal state and during PD with dialysates that contained dextrose alone in different concentrations (protocol 1: eight patients), (2) during PD with dialysates that contained dextrose alone or dextrose and amino acids (AA) (protocol 2: five patients), and (3) in time controls (five patients). PD with dextrose alone induced (1) a two- to threefold increase in insulin, as well as a 20 to 25% decrease in AA, mainly BCAA, levels; (2) an insulin-related decline (-18%) in forearm PB (P<0.