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Review
. 2010 Nov;30(6):627-34.
doi: 10.1016/j.semnephrol.2010.09.010.

Chronic kidney disease after hematopoietic stem cell transplantation

Eric P Cohen  1 , Priya Pais, John E Moulder
Affiliations
Review

Chronic kidney disease after hematopoietic stem cell transplantation

Eric P Cohen et al. Semin Nephrol. 2010 Nov.

Abstract

Acute and chronic kidney diseases occur after hematopoietic stem cell transplantation. These are caused by the transplant itself, and the complications of transplant. Recent estimates show that near 15% of subjects undergoing hematopoietic stem cell transplantation will develop chronic kidney disease, which is a complication rate that can affect outcome and reduce survival. Investigation of the causes of chronic kidney disease is needed, as are ways to prevent, mitigate, and treat it.

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Figures

Figure 1
Figure 1
The prevalence of chronic kidney disease after HSCT in children and adults. The pediatric studies are shown on the left, the adult studies on the right. The year of the study report is shown on the x axis, the percentage of subjects on the y axis. These data are for 2007 onwards, and from reports as cited (9-16). The arithmetic average for all studies is 13%.
Figure 2
Figure 2
Photomicrograph of a kidney biopsy of a man who developed acute lymphocytic leukemia in 2009. He received a hematopoietic stem cell transplant (HSCT) from an HLA matched sibling after conditioning with total body irradiation (1200 cGy over 3 days). He developed hemolytic uremic syndrome at 5 months after HSCT. His serum creatinine increased when his calcineurin inhibitor was stopped, so a kidney biopsy was done. The arrow shows the characteristic mesangiolysis (Jones stain, 400x)
Figure 3
Figure 3
The evolution of GFR as 100/s creatinine, for s creatinine in mg/dl, in another case of BMT nephropathy. The initial rapid decline of kidney function is evident. Use of captopril and control of the blood pressure has coincided with clear stabilization of the kidney function, albeit at a low level.
See this image and copyright information in PMC

References

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