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Published on: August 7, 2017
Chronic kidney disease after autologous stem cell transplantation: analysis of a single center experience
QiaoYuan Wu1, XiaoHong Li, YongRong Lai
1Department of Nephrology, The First Affiliated Hospital, Guangxi Medical University, No. 22, Shuang Yong Lu, Nanning, 530021, Guangxi, China.
Insights
Chronic kidney disease (CKD) after autologous hematopoietic stem cell transplantation (HSCT) affects 14.6% of patients. Mesangial proliferative glomerulonephritis and nephrotic syndrome are key findings, often responding to prednisone treatment.
Area of Science:
- Nephrology
- Hematology
- Oncology
Background:
- Chronic kidney disease (CKD) is a known complication following allogeneic hematopoietic stem cell transplantation (HSCT).
- CKD and its pathological changes after autologous HSCT are less frequently reported.
- Understanding these complications is crucial for patient management post-transplant.
Purpose of the Study:
- To determine the frequency of CKD in patients undergoing autologous HSCT.
- To analyze the clinical and pathological characteristics of CKD in this patient population.
- To investigate the efficacy of treatments for CKD post-autologous HSCT.
Main Methods:
- Retrospective study design.
- Screening of clinical records for patients who underwent autologous HSCT between May 2000 and November 2010.
- Acquisition of clinical and follow-up data for patients with kidney injury.
Main Results:
- Six out of 41 patients (14.6%) developed CKD after autologous HSCT.
- Proteinuria and nephrotic syndrome were common presentations; three patients had nephrotic syndrome.
- Renal biopsy in two patients revealed mesangial proliferative glomerulonephritis.
Conclusions:
- Mesangial proliferative glomerulonephritis may be a more common pathological finding in CKD post-autologous HSCT than previously recognized.
- Nephrotic syndrome is a frequent manifestation of CKD after HSCT.
- Prednisone monotherapy showed effectiveness in managing nephrotic syndrome in these patients.
Purpose:
Chronic kidney disease (CKD) after allogeneic hematopoietic stem cell transplantation (HSCT) has increasingly been reported. However, CKD after autologous HSCT, especially changes in renal pathology, has rarely been reported. This study aimed to evaluate the frequency of CKD among patients who received autologous HSCT for hematological and nonhematological disorders, and analyze its clinical and pathological features.
Methods:
We performed a retrospective study to evaluate the frequency of CKD after autologous HSCT and analyzed clinical and pathological features of CKD. Clinical records of patients who underwent autologous HSCT at the First Affiliated Hospital of Guangxi Medical University between May 2000 and November 2010 were screened. Clinical data of those with kidney injury on presentation and follow-up were acquired from hospital records.
Results:
A total of 41 patients who received autologous HSCT were identified. CKD developed in six patients (14.6%). Among the six patients, all had various degrees of proteinuria and three patients had nephrotic syndrome. Impaired renal function occurred in three patients. Three patients with nephrotic syndrome received only prednisone. Two patients obtained complete remission, and one had partial remission. What is particularly worth mentioning is, in two patients who received renal biopsy in our study, the pathological changes were mesangial proliferative glomerulonephritis.
Conclusions:
Mesangial proliferative glomerulonephritis may not be as uncommon as previously thought in CKD patients after autologous HSCT. Presentation of nephrotic syndrome is common in CKD after HSCT and prednisone alone are effective.
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