Glomerular diseases post-hematopoietic stem cell transplantation: pathologic spectrum and plausible mechanisms

Glomerular disease is an important complication in patients undergoing hematopoietic stem cell transplantation (HSCT), impacting approximately 1%-2% of all HSCT recipients and equating to 700-1400 cases per year worldwide. Development of kidney disease in HSCT recipients is often multifactorial and a kidney biopsy is required to identify the underlying disease etiology and pathology. While glomerular disease is an important toxicity following HSCT, there are few kidney biopsy studies examining this complication, with the majority being limited to small series and case reports. A range of glomerular diseases may occur in association with HSCT. The study by Yap et al. defines this disease spectrum, which includes (in descending order) thrombotic microangiopathy (38.7%), membranous nephropathy (25.8%), mesangial proliferative glomerulonephritis (12.9%), minimal change disease (9.7%), focal segmental glomerulosclerosis (9.7%) and membranoproliferative glomerulonephritis (3.2%). In this editorial, we summarize the study and prior studies looking at glomerular diseases associated with HSCT.