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American Journal of Kidney Diseases

Kidney Complications of Hematopoietic Stem Cell Transplantation

  • Author Footnotes
    ⁎ Current affiliation: Department of Internal Medicine, Division of Nephrology, Louisiana State University Health Sciences Center, Shreveport, LA.
    Neeraj Singh
    Correspondence
    Address correspondence to Neeraj Singh, MBBS, LSUHSC-Shreveport, 1501 Kings Hwy, Shreveport, LA 71115
    Footnotes
    ⁎ Current affiliation: Department of Internal Medicine, Division of Nephrology, Louisiana State University Health Sciences Center, Shreveport, LA.
    Affiliations
    Department of Internal Medicine, Division of Nephrology, The Ohio State University College of Medicine and Public Health, Columbus, OH
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  • Jonathan McNeely
    Affiliations
    Department of Internal Medicine, Division of Nephrology, The Ohio State University College of Medicine and Public Health, Columbus, OH
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  • Samir Parikh
    Affiliations
    Department of Internal Medicine, Division of Nephrology, The Ohio State University College of Medicine and Public Health, Columbus, OH
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  • Arvinder Bhinder
    Affiliations
    Department of Internal Medicine, Division of Medical Oncology, The Ohio State University College of Medicine and Public Health, Columbus, OH
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  • Brad H. Rovin
    Affiliations
    Department of Internal Medicine, Division of Nephrology, The Ohio State University College of Medicine and Public Health, Columbus, OH
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  • Ganesh Shidham
    Affiliations
    Department of Internal Medicine, Division of Nephrology, The Ohio State University College of Medicine and Public Health, Columbus, OH
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  • Author Footnotes
    ⁎ Current affiliation: Department of Internal Medicine, Division of Nephrology, Louisiana State University Health Sciences Center, Shreveport, LA.
Published:January 07, 2013DOI:https://doi.org/10.1053/j.ajkd.2012.09.020
      Hematopoietic stem cell transplantation (HSCT) exposes a patient's kidneys to a unique combination of challenges, including high-dose radiation, anemia, chemotherapeutic agents, graft-versus-host disease, opportunistic infections, attenuated and altered immunologic responses, fluid and electrolyte imbalances, and extensive courses of antimicrobial agents. Since the inception of HSCT in the 1950s, there has been increasing interest in defining, determining, and managing the kidney complications that accompany this procedure. In this article, we review the common causes of acute kidney injury and chronic kidney disease that occur with HSCT, including HSCT-associated thrombotic microangiopathy, a distinct cause of chronic kidney disease with a multifactorial cause previously known as bone marrow transplant nephropathy or radiation nephropathy. Additionally, we review other kidney complications, including calcineurin inhibitor nephrotoxicity and chronic graft-versus-host disease–associated glomerulonephritis, that develop post-HSCT. Critically, due to its grave prognosis, it is important to identify HSCT-associated thrombotic microangiopathy early, as well as distinguish it from the other causes of chronic kidney disease.

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