Chronic kidney disease in long-term survivors of hematopoietic cell transplant

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S Hingorani1, K A Guthrie, G Schoch

  • 1Department of Pediatrics, University of Washington, Seattle, WA 98105, USA. sangeeta.hingorani@seattlechildrens.org

Bone Marrow Transplantation
|February 10, 2007
PubMed

Insights

Chronic kidney disease (CKD) affects 23% of long-term hematopoietic cell transplant (HCT) survivors. Acute renal failure and graft-vs-host disease significantly increase CKD risk.

Area of Science:

  • Nephrology
  • Hematology
  • Oncology

Background:

  • Hematopoietic cell transplantation (HCT) is a life-saving procedure for various hematologic malignancies and other conditions.
  • Long-term survivors of HCT face a risk of developing chronic health complications, including kidney disease.
  • Identifying risk factors for chronic kidney disease (CKD) post-HCT is crucial for patient management and outcomes.

Purpose of the Study:

  • To identify risk factors associated with the development of chronic kidney disease (CKD) in long-term survivors of hematopoietic cell transplant (HCT).

Main Methods:

  • A cohort study was conducted involving 1635 patients who underwent HCT between 1991 and 2002.
  • CKD was defined as a glomerular filtration rate < 60 ml/min/m(2) on two occasions between days 100 and 540 post-transplant.
  • Cox regression models were used to analyze associations between demographic and clinical variables and CKD risk.

Main Results:

  • A total of 376 patients (23%) developed CKD at a median of 191 days post-transplant.
  • Factors associated with an increased risk of CKD included acute renal failure (ARF) (HR=1.7) and acute graft-vs-host disease (aGVHD) grades II (HR=2.0) and III/IV (HR=3.1).
  • Chronic graft-vs-host disease (GVHD) (HR=1.8) was also associated with increased CKD risk, while total body irradiation (TBI) was not (HR=1.0).

Conclusions:

  • Chronic kidney disease is a significant concern for long-term survivors of HCT.
  • The occurrence of ARF and GVHD are identified as key risk factors for developing CKD after HCT.
  • Receipt of TBI was not found to be associated with an increased risk of CKD in this cohort.

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