title: Long-term renal function following bone marrow transplantation.
abstract: Renal function, evaluated as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), was investigated in 187 pediatric patients who underwent allogeneic (n=169) or autologous bone marrow transplantation (BMT). Allogeneic BMT patients were divided into three groups: hematological malignancies, aplastic anemia and non-malignant diseases, whereas autologous patients constituted a fourth group. A total of 64% received total body irradiation (TBI) as conditioning therapy, and 50 healthy children served as controls. GFR and ERPF were normal before transplantation. After 1 year, both GFR and ERPF were significantly reduced. GFR had recovered slightly after 3 years and remained stable thereafter. Recovery in ERPF was not apparent. Renal impairment was found in 41% of patients at 1 year, in 31% at 3 years and in 11% 7 years after BMT. Patients with hematological malignancies had lower GFRs than patients with non-malignant diseases at all time points. The most important risk factor as regards chronic renal impairment was TBI. Type of donor, cyclophosphamide (CY), or acute graft-versus-host disease (GVHD) did not seem to contribute to the development of chronic renal impairment. We suggest that tests of renal function should be included in long-term followup after BMT.
authors.affiliation: Department of Pediatrics, Turku University Central Hospital, Turku, Finland.
authors.forename: M H
authors.initials: MH
authors.lastname: Grönroos
authors.forename: P
authors.initials: P
authors.lastname: Bolme
authors.forename: J
authors.initials: J
authors.lastname: Winiarski
authors.forename: U B
authors.initials: UB
authors.lastname: Berg
mesh_terms: D000293:Adolescent; D000741:Anemia, Aplastic / Q000628:therapy; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006086:Graft vs Host Disease / Q000150:complications; D019337:Hematologic Neoplasms / Q000628:therapy; D006801:Humans; D007223:Infant; D007668:Kidney / Q000502:physiology*; D007676:Kidney Failure, Chronic / Q000209:etiology*; D007677:Kidney Function Tests; D008297:Male; D012079:Renal Circulation; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation / Q000009:adverse effects