*Purpose: BK viremia (BKV) is a deleterious complication after renal transplantation that can compromise allograft function. Centers face the challenge of identifying at-risk patients and developing monitoring strategies. The purpose of this study is to determine the incidence of BKV and to identify potential risk factors for the development BKV within 1 year post-renal transplant within an adult urban transplant population.

*Methods: Single center, retrospective cohort study of adult isolated renal transplant recipients at the University of Illinois Hospital and Health Sciences System from 01/01/2015t o 12/31/2018. BKV was defined as any BK DNA detected via polymerase chain reaction (PCR) in the blood. Time to BKV was assessed with a Kaplan Meier curves with logrank comparisons for different patient and immunosuppression characteristics.

*Results: 361 patients were assessed and a majority were male (62.6%) and African-American (46.8%). Demographic information is detailed in Table 1. The incidence of early positive BK PCR was 22.7%. Median time to first BK viremia was 127.5 days (IQR 60 – 273) days. Patient eGFR at time of BK viremia was 55.9 (+ 20.9) ml/min/1.73. Table 1 shows results of further analysis of the BK PCR positive cohort. Time to BKV was significantly different by race (p = 0.015) and induction modality (p=0.04). Figure 2 illustrates time to BKV.

*Conclusions: Incidence and time to BKV differs by patient race and induction immunosuppression. Examination of center-specific BKV development will assist in optimizing BKV monitoring and further protocol optimization.

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