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Curr Opin Crit Care · Dec 2019
ReviewAcute kidney injury in hematopoietic stem cell transplantation.
- Rimda Wanchoo, Brian R Stotter, Ruthee L Bayer, and Kenar D Jhaveri.
- Division of Kidney Diseases and Hypertension.
- Curr Opin Crit Care. 2019 Dec 1; 25 (6): 531-538.
Purpose Of ReviewAcute 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 recipients SUMMARY: This review provides an update on the risk factors, causes, and treatment approaches to HSCT-associated AKI.
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