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Related Experiment Videos

Renal dysfunction in allogeneic hematopoietic cell transplantation.

Chirag R Parikh1, Peter A McSweeney, Didem Korular

  • 1Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado School of Medicine, Denver, Colorado, USA.

Kidney International
|July 12, 2002
PubMed
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Allogeneic hematopoietic cell transplantation (HCT) frequently causes kidney problems, with 92% of patients experiencing renal dysfunction. Severe kidney issues significantly increase mortality risk, highlighting the need for closer monitoring during HCT recovery.

Area of Science:

  • Nephrology
  • Hematology
  • Oncology

Background:

  • Allogeneic hematopoietic cell transplantation (HCT) offers potential cures for various diseases but carries significant toxicity risks.
  • Previous studies indicated a 21% incidence of severe acute renal failure in autologous HCT.
  • This study specifically investigates renal dysfunction following allogeneic HCT.

Purpose of the Study:

  • To evaluate the incidence and severity of renal dysfunction in adult patients undergoing allogeneic HCT.
  • To identify correlations between renal dysfunction and other toxicities or outcomes.

Main Methods:

  • Analysis of the clinical course of 88 adult patients who underwent allogeneic HCT.
  • Classification of renal dysfunction into four grades (0-3) based on GFR decrement and serum creatinine levels, including need for dialysis.

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Main Results:

  • A high incidence of renal dysfunction (92%) was observed across 88 patients.
  • Grade 1: 20 patients, Grade 2: 32 patients, Grade 3: 29 patients.
  • Severe nephrotoxicity (Grades 2 and 3) correlated with increased sepsis, hepatic toxicity (including VOD), and lung toxicity. Overall 6-month mortality was 58%, with Grade 3 renal dysfunction associated with 82.6% mortality.

Conclusions:

  • Allogeneic HCT is associated with a very high incidence (92%) of renal dysfunction.
  • Lung and liver toxicities are significantly correlated with the development of renal dysfunction.
  • Grade 3 renal failure in allogeneic HCT patients carries an extremely high mortality rate exceeding 80%.