BK Polyomavirus-Associated Nephropathy After Kidney Transplantation: Advances in Diagnostics, Surveillance, and Management.

BK polyomavirus remains an important cause of allograft dysfunction and graft loss in kidney transplant recipients. Current consensus emphasizes early detection of viremia and timely immunosuppression reduction as the cornerstone of management. Novel diagnostic adjuncts, including donor -derived cell -free DNA, urinary biomarkers, and risk prediction models, are under investigation for more precise stratification of patients at risk for BK polyomavirus -associated nephropathy. Conventional antivirals have shown inconsistent efficacy ; however, recent interest has focused on adoptive virus -specific T -cell therapy and neutralizing antibodies for refractory cases. This review reports the current understanding of BK polyomavirus epidemiology, diagnostics, management strategies, and emerging therapies, with emphasis on practical application of guidelines and identification of future research directions.