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Chronic kidney disease after nonmyeloablative stem cell transplantation in adults

Sabina Kersting1, Leo F Verdonck

  • 1Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands. s.kersting@umcutrecht.nl

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
|March 18, 2008
PubMed

Insights

Chronic kidney disease (CKD) is common after nonmyeloablative stem cell transplantation (SCT). Female sex, older age, and pre-existing reduced kidney function are key risk factors for developing CKD post-SCT.

Area of Science:

  • Nephrology
  • Hematology
  • Oncology

Background:

  • Chronic kidney disease (CKD) is a known complication following myeloablative stem cell transplantation (SCT).
  • Limited data exists regarding the incidence and risk factors of CKD after nonmyeloablative SCT (NMSCT).

Purpose of the Study:

  • To investigate the occurrence of CKD in patients undergoing NMSCT.
  • To identify risk factors associated with CKD development post-NMSCT.
  • To determine the impact of CKD on overall survival after NMSCT.

Main Methods:

  • Retrospective cohort study of 108 adult patients who received NMSCT.
  • Renal function assessed using estimated glomerular filtration rate (eGFR) via the MDRD equation.
  • CKD defined as eGFR <60 mL/min/1.73 m²; incidence and risk factors analyzed.

Main Results:

  • CKD developed in 15% of patients, with a cumulative incidence of 22% at 48 months post-NMSCT.
  • No patients required dialysis; SCT nephropathy was not observed.
  • Significant risk factors for CKD included female sex (P=.021), older age (P=.040), and lower pretransplant eGFR (P<.001).

Conclusions:

  • CKD is a frequent complication after NMSCT, distinct from SCT nephropathy seen in myeloablative SCT.
  • Female patients, those over 50, and individuals with pre-existing renal impairment face a higher risk of CKD.
  • CKD did not significantly impact overall survival in this cohort (66% OS).

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