Katherine A. Barraclough

Detection of Recently Discovered Human Polyomaviruses in a Longitudinal Kidney Transplant Cohort

A large number of human polyomaviruses have been discovered in the last 7 years. However, little is known about the clinical impact on vulnerable immunosuppressed patient populations. Blood, urine, and respiratory swabs collected from a prospective, longitudinal adult kidney transplant cohort (n = 167) generally pre‐operatively, at day 4, months 1, 3, and 6 posttransplant, and at BK viremic episodes within the first year were screened for 12 human polyomaviruses using real‐time polymerase chain reaction. Newly discovered polyomaviruses were most commonly detected in the respiratory tract, with persistent shedding seen for up to 6 months posttransplant. Merkel cell polyomavirus was the most common detection, but was not associated with clinical symptoms or subsequent development of skin cancer or other skin abnormalities. In contrast, KI polyomavirus was associated with respiratory disease in a subset of patients. Human polyomavirus 9, Malawi polyomavirus, and human polyomavirus 12 were not detected in any patient samples.

Specific rolling circle amplification of low-copy human polyomaviruses BKV, HPyV6, HPyV7, TSPyV, and STLPyV.

Eleven new human polyomaviruses have been recently discovered, yet for most of these viruses, little is known of their biology and clinical impact. Rolling circle amplification (RCA) is an ideal method for the amplification of the circular polyomavirus genome due to its high fidelity amplification of circular DNA. In this study, a modified RCA method was developed to selectively amplify a range of polyomavirus genomes. Initial evaluation showed a multiplexed temperature-graded reaction profile gave the best yield and sensitivity in amplifying BK polyomavirus in a background of human DNA, with up to 1 × 10(8)-fold increases in viral genomes from as little as 10 genome copies per reaction. Furthermore, the method proved to be more sensitive and provided a 200-fold greater yield than that of random hexamers based standard RCA. Application of the method to other novel human polyomaviruses showed successful amplification of TSPyV, HPyV6, HPyV7, and STLPyV from low-viral load positive clinical samples, with viral genome enrichment ranging from 1 × 10(8) up to 1 × 10(10). This directed RCA method can be applied to selectively amplify other low-copy polyomaviral genomes from a background of competing non-specific DNA, and is a useful tool in further research into the rapidly expanding Polyomaviridae family.

Climate change and kidney disease—threats and opportunities

Grant A. Blashki, Steve G. Holt and John W.M. Agar Department of Nephrology, Royal Melbourne Hospital, Parkville, Victoria, Australia; The Nossal Institute for Global Health, The University of Melbourne, Parkville, Victoria, Australia; and Department of Renal Medicine, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia Correspondence: Katherine Barraclough, Department of Nephrology, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia. E-mail: Katherine. barraclough@mh.org.au nephro log i s t s sans f ron t i è re s www.k i dney i n te rna t i ona l . o rg

The Green Dialysis Survey: Establishing a Baseline for Environmental Sustainability across Dialysis Facilities in Victoria, Australia

The Green Dialysis Survey aimed to (i) establish a baseline for environmental sustainability (ES) across Victorian dialysis facilities; and (ii) guide future initiatives to reduce the environmental impact of dialysis delivery.

Climate change and us: What nephrologists should know

Global warming poses significant risks to human health and the planet. If allowed to continue unchecked, its consequences will be devastating. While all populations will be effected with time, vulnerable groups, including those with kidney disease, are likely to be at primary risk. This paper summarizes the current state of scientific knowledge relevant to climate change. It discusses the contribution of the health‐care system, and particularly dialysis programmes, to greenhouse gas emissions, and pathways that exist for nephrologists to mitigate their environmental impact.