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Chronic kidney disease after myeloablative allogeneic hematopoietic stem cell transplantation.
Biol Blood Marrow Transplant. 2007 Oct; 13(10):1169-75.BB

Abstract

Because survival of recipients of allogeneic hematopoietic stem cell transplantation (HSCT) has improved, long-term complications become more important. We studied the incidence and risk factors of chronic kidney disease in these patients and evaluated associated posttransplant complications and mortality. We performed a retrospective cohort study of 266 adults who received myeloablative allogeneic HSCT and who survived for >6 months in an 11-year period at a Dutch university medical center. Primary outcome was the incidence of chronic kidney disease defined as a glomerular filtration rate (GFR) of <60 mL/min/1.73 m(2). Chronic kidney disease developed in 61 (23%) of 266 patients, with a cumulative incidence rate of 27% at 10 years. Severe kidney disease (GFR of <30 mL/min/1.73 m(2)) developed in 3% of patients. Only 6 patients developed the thrombotic microangiopathic syndrome SCT nephropathy, and 2 of them needed dialysis. Pretransplant risk factors for chronic kidney disease were lower GFR at day 0 (P < .0001, odds ratio [OR] 0.95 95% confidence interval [CI] 0.93-0.97), female gender, and higher age (P = .001 and P < .0001, respectively). The occurrence of hypertension after transplantation was associated with chronic kidney disease (P < .0001, OR 0.34 95% CI 0.18-0.62). Mortality was 39% after a mean follow-up of 5.1 years. There was no significant difference in survival between patients with and without chronic kidney disease. Chronic kidney disease is a common late complication of myeloablative allogeneic HSCT. Because of the natural decline in renal function with time there is a risk of developing end-stage renal disease in the future. SCT nephropathy seems to be a specific cause of chronic kidney disease that is typically associated with severe kidney disease.

Authors+Show Affiliations

Departments of Hematology, University Medical Centre Utrecht, Utrecht, The Netherlands. s.kersting@umcutrecht.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17889353

Citation

Kersting, Sabina, et al. "Chronic Kidney Disease After Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 13, no. 10, 2007, pp. 1169-75.
Kersting S, Hené RJ, Koomans HA, et al. Chronic kidney disease after myeloablative allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2007;13(10):1169-75.
Kersting, S., Hené, R. J., Koomans, H. A., & Verdonck, L. F. (2007). Chronic kidney disease after myeloablative allogeneic hematopoietic stem cell transplantation. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 13(10), 1169-75.
Kersting S, et al. Chronic Kidney Disease After Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant. 2007;13(10):1169-75. PubMed PMID: 17889353.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic kidney disease after myeloablative allogeneic hematopoietic stem cell transplantation. AU - Kersting,Sabina, AU - Hené,Ronald J, AU - Koomans,Hein A, AU - Verdonck,Leo F, Y1 - 2007/07/27/ PY - 2007/02/15/received PY - 2007/06/15/accepted PY - 2007/9/25/pubmed PY - 2007/12/7/medline PY - 2007/9/25/entrez SP - 1169 EP - 75 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 13 IS - 10 N2 - Because survival of recipients of allogeneic hematopoietic stem cell transplantation (HSCT) has improved, long-term complications become more important. We studied the incidence and risk factors of chronic kidney disease in these patients and evaluated associated posttransplant complications and mortality. We performed a retrospective cohort study of 266 adults who received myeloablative allogeneic HSCT and who survived for >6 months in an 11-year period at a Dutch university medical center. Primary outcome was the incidence of chronic kidney disease defined as a glomerular filtration rate (GFR) of <60 mL/min/1.73 m(2). Chronic kidney disease developed in 61 (23%) of 266 patients, with a cumulative incidence rate of 27% at 10 years. Severe kidney disease (GFR of <30 mL/min/1.73 m(2)) developed in 3% of patients. Only 6 patients developed the thrombotic microangiopathic syndrome SCT nephropathy, and 2 of them needed dialysis. Pretransplant risk factors for chronic kidney disease were lower GFR at day 0 (P < .0001, odds ratio [OR] 0.95 95% confidence interval [CI] 0.93-0.97), female gender, and higher age (P = .001 and P < .0001, respectively). The occurrence of hypertension after transplantation was associated with chronic kidney disease (P < .0001, OR 0.34 95% CI 0.18-0.62). Mortality was 39% after a mean follow-up of 5.1 years. There was no significant difference in survival between patients with and without chronic kidney disease. Chronic kidney disease is a common late complication of myeloablative allogeneic HSCT. Because of the natural decline in renal function with time there is a risk of developing end-stage renal disease in the future. SCT nephropathy seems to be a specific cause of chronic kidney disease that is typically associated with severe kidney disease. SN - 1083-8791 UR - https://www.unboundmedicine.com/medline/citation/17889353/Chronic_kidney_disease_after_myeloablative_allogeneic_hematopoietic_stem_cell_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(07)00321-7 DB - PRIME DP - Unbound Medicine ER -