Acute kidney injury in hematopoietic stem cell transplantation

Rimda Wanchoo, Brian R. Stotter, Ruthee L. Bayer, Kenar D. Jhaveri

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations

Abstract

Purpose of review Acute kidney injury (AKI) in the setting of hematopoietic stem cell transplantation (HSCT) is common in pediatric and adult patients. The incidence ranges from 12 to 66%, and development of AKI in the posttransplant course is independently associated with higher mortality.Recent findingsPatients who undergo HSCT have many risk factors for developing AKI, including sepsis, use of nephrotoxic medications, graft versus host disease (GVHD), and veno-occlusive disease (VOD). In addition, engraftment syndrome/cytokine storm, transplant-associated thrombotic microangiopathy (TA-TMA), and less common infections with specific renal manifestations, such as BK and adenovirus nephritis, may lead to kidney injury. There has been significant advancement in the understanding of TA-TMA in particular, especially the role of the complement system in its pathophysiology. The role of early dialysis has been explored in the pediatric population, but not well studied in adult HSCT recipientsSummaryThis review provides an update on the risk factors, causes, and treatment approaches to HSCT-associated AKI.Video abstracthttp://links.lww.com/COCC/A29.

Original languageEnglish
Pages (from-to)531-538
Number of pages8
JournalCurrent Opinion in Critical Care
Volume25
Issue number6
DOIs
StatePublished - Dec 1 2019

Keywords

  • acute kidney injury
  • bone marrow transplant
  • hematopoietic stem cell transplantation
  • onconephrology
  • thrombotic microangiopathy

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