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JC viruria associates with reduced risk of diabetic kidney disease.

Purpose: African Americans who shed JC polyoma virus (JCV) in their urine have reduced rates of non-diabetic chronic kidney disease (CKD). The present study assessed associations between urinary JCV and urine BK polyomavirus (BKV) with CKD in African Americans with diabetes mellitus.

Methods: African Americans with diabetic kidney disease and controls lacking nephropathy from the Family Investigation of Nephropathy and Diabetes Consortium (FIND) and African American-Diabetes Heart Study (AA-DHS) had urine tested for JCV and BKV using quantitative polymerase chain reaction. Among 335 individuals tested, 148 were cases with diabetic kidney disease and 187 were controls.

Results: JCV viruria was detected more often in controls than in cases with diabetic kidney disease, respectively (FIND: 46.6% vs. 32.2%, odds ratio [OR] 0.52, 95% confidence interval [CI] 0.29-0.93; p=0.03; AA-DHS: 30.4% vs. 26.2%, OR 0.63, 95% CI 0.27-1.48; p=0.29). A joint-analysis adjusting for age, gender and study revealed that JC viruria was inversely associated with diabetic kidney disease (OR 0.56, 95% CI 0.35-0.91; p=0.02). Significant relationships between BKV and diabetic kidney disease were not observed.

Main Conclusions: This study extends the inverse association between urine JCV and non-diabetic nephropathy in African Americans to diabetic kidney disease. Results imply that common pathways likely involving the innate immune system mediate coincident chronic kidney injury along with restriction of JCV replication. Future studies are needed to explore causative pathways and characterize whether absence of JC viruria can serve as a biomarker for diabetic kidney disease in the African American population.

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