1. Acute kidney injury in hematopoietic stem cell transplantation
- Author
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Rimda Wanchoo, Kenar D. Jhaveri, Brian R. Stotter, and Ruthee L. Bayer
- Subjects
Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Hematopoietic stem cell transplantation ,urologic and male genital diseases ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Kidney injury ,Humans ,Adult patients ,urogenital system ,business.industry ,Incidence (epidemiology) ,Acute kidney injury ,Hematopoietic Stem Cell Transplantation ,030208 emergency & critical care medicine ,Acute Kidney Injury ,medicine.disease ,female genital diseases and pregnancy complications ,surgical procedures, operative ,030228 respiratory system ,business - Abstract
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.Patients 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.
- Published
- 2019