Acute kidney injury and CKD associated with hematopoietic stem cell transplantation Journal Article


Authors: DeMauro Renaghan, A.; Jaimes, E. A.; Malyszko, J.; Perazella, M. A.; Sprangers, B.; Rosner, M. H.
Article Title: Acute kidney injury and CKD associated with hematopoietic stem cell transplantation
Abstract: Hematopoietic stem cell transplantation is a life-saving therapy for many patients with cancer, as well as patients with some nonmalignant hematologic disorders, such as aplastic anemia, sickle cell disease, and certain congenital immune deficiencies. Kidney injury directly associated with stem cell transplantation includes a wide range of structural and functional abnormalities, which may be vascular (hypertension, thrombotic microangiopathy), glomerular (albuminuria, nephrotic glomerulopathies), and/or tubulointerstitial. AKI occurs commonly after stem cell transplant, affecting 10%–73% of patients. The cause is often multifactorial and can include sepsis, nephrotoxic medications, marrow infusion syndrome, hepatic sinusoidal obstruction syndrome, thrombotic microangiopathy, infections, and graft versus host disease. The risk of post-transplant kidney injury varies depending on patient characteristics, type of transplant (allogeneic versus autologous), and choice of chemo-therapeutic conditioning regimen (myeloablative versus nonmyeloablative). Importantly, AKI is associated with substantial morbidity, including the need for KRT in approximately 5% of patients and the development of CKD in up to 60% of transplant recipients. AKI has been associated universally with higher all-cause and nonrelapse mortality regardless of transplant type, and studies have consistently shown extremely high (>80%) mortality rates in those patients requiring acute dialysis. Accordingly, prevention, early recognition, and prompt treatment of kidney injury are essential to improving kidney and patient outcomes after hematopoietic stem cell transplantation, and for realizing the full potential of this therapy. © 2020 by the American Society of Nephrology.
Keywords: mortality; review; methotrexate; nephrotoxicity; anemia; thrombocytopenia; aciclovir; cyclophosphamide; steroid; hematopoietic stem cell transplantation; risk factor; hyperuricemia; tumor lysis syndrome; acute kidney failure; myeloablative conditioning; sulfonamide; ciprofloxacin; graft versus host reaction; sepsis; glomerulus filtration rate; oxidative stress; cystatin c; vancomycin; immunosuppressive treatment; calcineurin inhibitor; fatty acid binding protein; haptoglobin; thrombotic thrombocytopenic purpura; adenovirus infection; chronic kidney failure; nephrotic syndrome; albuminuria; drug exposure; neutrophil gelatinase associated lipocalin; fluid retention; gemtuzumab ozogamicin; virus reactivation; piperacillin plus tazobactam; gram negative sepsis; pravastatin; membrane cofactor protein; liver venoocclusive disease; hepatorenal syndrome; aminoglycoside; inotuzumab ozogamicin; kidney graft; lectin; defibrotide; kidney perfusion; hyperphosphatemia; amphotericin b deoxycholate; fanconi renotubular syndrome; human; interstitial nephritis; glomerulopathy; kidney tubule disorder; bartter syndrome; all cause mortality; bk virus infection; renin angiotensin aldosterone system; alternative complement pathway c3 c5 convertase; complement factor i; limaprost; recombinant thrombomodulin; marrow infusion syndrome; tubular dysfunction
Journal Title: Clinical Journal of the American Society of Nephrology
Volume: 15
Issue: 2
ISSN: 1555-9041
Publisher: Amer Soc Nephrology  
Date Published: 2020-02-07
Start Page: 289
End Page: 297
Language: English
DOI: 10.2215/cjn.08580719
PUBMED: 31836598
PROVIDER: scopus
DOI/URL:
Notes: Review -- Export Date: 2 March 2020 -- Source: Scopus
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  1. Edgar Alberto Jaimes
    33 Jaimes