title: Nephrotic Syndrome After Hematopoietic Stem Cell Transplant: Outcomes in Iran.
abstract: OBJECTIVE
  Patients undergoing hematopoietic stem cell transplant have an elevated incidence of acute renal failure. However, the incidence of nephritic syndrome due to graft-versus-host disease is growing and is independently associated with chronic renal disease after this procedure.
  
  
  METHODS
  We conducted a prospective study to examine the risk of chronic kidney disease in glomerulopathy patients following hematopoietic stem cell transplant with a follow-up of 10 years.
  
  
  RESULTS
  In our follow-up of 14 patients (4 men and 10 women) who were diagnosed with nephrotic syndrome after hematopoietic stem cell transplant, in 10 patients (71%), biopsy showed membranous nephropathy associated with graft-versus-host disease. The remaining 4 patients had focal segmental glomerulosclerosis, membranoproliferative glomerulonephritis, or minimal change disease. All patients were treated with angiotensin receptor blockers, cyclosporine (Neoral), and prednisolone. During follow-up, 6 patients (43%) had heavy proteinuria and a rise in serum creatinine, and 1 patient (7%) needed hemodialysis. Eleven patients (79%) achieved complete remission of nephrotic syndrome, 5 (36%) remained hypertensive, and 3 (21%) did not respond to therapy..
  
  
  CONCLUSIONS
  The early diagnosis of nephrotic syndrome should be considered after hematopoietic stem cell transplant, and therapeutic outcome measures should be in place in advance. If this is done, we found that patients' response to treatment can be optimal, and their renal function and overall survival can improve.
authors.affiliation: Nephrology and Transplant Ward, Hashemi Nejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Saddadi
authors.forename: Ali
authors.initials: A
authors.lastname: Alidadi
authors.forename: Monir
authors.initials: M
authors.lastname: Hakemi
authors.forename: Babak
authors.initials: B
authors.lastname: Bahar
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D001706:Biopsy; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005923:Glomerulosclerosis, Focal Segmental / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007492:Iran; D008297:Male; D009402:Nephrosis, Lipoid / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011446:Prospective Studies; D012074:Remission Induction; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D057911:Angiotensin Receptor Antagonists; D007166:Immunosuppressive Agents