title: Prospective study of renal insufficiency after bone marrow transplantation.
abstract: Since more and more children survive allogeneic bone marrow transplantation (BMT), knowledge of acute and late complications becomes increasingly important. Besides the major complications [(opportunistic) infections, veno-occlusive disease, graft versus host disease, and recurrence of primary disease], acute and chronic renal insufficiency are significant post-transplant complications that may contribute to transplant-related mortality. To elucidate risk factors for acute and chronic renal insufficiency post BMT, we performed a prospective study of all 66 children who received a BMT in a 2-year period at our institution; 21% had acute renal insufficiency post BMT. Risk factors for acute renal insufficiency were veno-occlusive disease, high cyclosporin serum levels, and foscarnet therapy. Of surviving patients, 11% developed chronic renal insufficiency 1 year post BMT. Acute renal insufficiency was the sole predictor of chronic renal insufficiency. In contrast to studies in adults, we did not find total body irradiation to be a risk factor for chronic renal insufficiency. Future long-term studies are needed to assess incidence and morbidity of chronic renal insufficiency in children following allogeneic BMT.
authors.affiliation: Department of Pediatrics, Leiden University Medical Center, The Netherlands. joana@kist.nl
authors.forename: Joana E
authors.initials: JE
authors.lastname: Kist-van Holthe
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Goedvolk
authors.forename: Ronald
authors.initials: R
authors.lastname: Brand
authors.forename: Margreet H
authors.initials: MH
authors.lastname: van Weel
authors.forename: Robbert G M
authors.initials: RG
authors.lastname: Bredius
authors.forename: Jacques A
authors.initials: JA
authors.lastname: van Oostayen
authors.forename: Jacques M J J
authors.initials: JM
authors.lastname: Vossen
authors.forename: Bert J
authors.initials: BJ
authors.lastname: van der Heijden
mesh_terms: D058186:Acute Kidney Injury / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D007678:Kidney Glomerulus / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D013601:T-Lymphocytes / Q000502:physiology; D014463:Ultrasonography