title: The kidney effects of hematopoietic stem cell transplantation.
abstract: Hematopoietic stem cell transplant (HSCT) patients are at risk for acute kidney disease and CKD, which confer excess morbidity and mortality in this patient population. A main cause of acute kidney injury (AKI) in stem cell recipients is prerenal azotemia, but acute tubular necrosis (ATN), obstruction, marrow transfusion toxicity, and hepatic sinusoidal obstruction syndrome also contribute. AKI is an important risk factor for death and CKD among HSCT survivors. CKD is a growing complication of HSCT as more patients are transplanted and survival improves. For most patients, the exact etiology of CKD is never identified, but graft vs host disease and thrombotic microangiopathy are important diagnoses to consider. Stem cell transplant patient survival on dialysis is generally poor, but kidney transplantation is a safe and reasonable option for HSCT recipients who progress to ESRD.
authors.affiliation: Renal, Electrolyte, and Hypertension Division, Hospital of the University of Pennsylvania, Philadelphia, PA. Electronic address: Deirdre.sawinski@uphs.upenn.edu.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Sawinski
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D053099:Azotemia / Q000209:etiology; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D016030:Kidney Transplantation; D007683:Kidney Tubular Necrosis, Acute / Q000209:etiology; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D057049:Thrombotic Microangiopathies / Q000209:etiology
keywords: Acute kidney injury; Chronic kidney disease; End-stage renal disease; Hematopoietic stem cell transplant; Kidney transplantation