Background: BK nephropathy is an evolving challenge among kidney transplant recipients. Diagnosis of BK nephropathy depends on the presence of BK viral inclusions on renal biopsy. Most cases of BK nephropathy are preceded by BK viremia or viruria.
Case report: We report a case of BK nephropathy found on protocol renal transplant biopsy without associated BK viremia or viruria.
Conclusions: BK nephropathy may occur even in the absence of BK viremia or viruria. Protocol biopsy is a useful tool to detect these cases.