A 30-year-old male, a case of chronic kidney disease Stage 5D on peritoneal dialysis, underwent compatible blood group renal transplant with uncomplicated immediate posttransplant course. He developed significant graft dysfunction 2 months after transplant and the evaluation confirmed pelviureteric junction stenosis and Grade II hydroureteronephrosis of graft kidney. Percutaneous nephrostomy followed by antegrade double-J stenting of the graft kidney resulted in improvement of his serum creatinine. Significantly raised BK virus (BKV) levels were attributed as the cause of pelviureteric stenosis, which was treated with reduction of immunosuppression and intravenous immunoglobulin. The graft kidney biopsy did not reveal evidence of BKV nephropathy or rejection. This case highlights a rare presentation of pelviureteric stenosis secondary to BKV infection, which is mostly reported at distal ureter or ureterovesical junction after renal transplant.
Akal et al. (Thu,) studied this question.