USMLE Step 3 Quiz
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A 38-year-old man who is 9 months post-kidney transplant presents with a progressive rise in his serum creatinine from a baseline of 1.5 mg/dL to 2.4 mg/dL over the past 6 weeks. He has no other symptoms. His immunosuppressive regimen is tacrolimus, mycophenolate, and prednisone. A quantitative urine PCR is positive for BK polyomavirus with a viral load of 100,000 copies/mL. A renal biopsy is pending. What is the most appropriate initial management step?
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