Acute kidney injury in hematopoietic stem cell transplantation

Publication Date

2019

Journal Title

Curr Opin Crit Care

Abstract

© 2019 Wolters Kluwer Health, Inc. 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 findings 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. Video abstract http://links.lww.com/COCC/A29.

Volume Number

25

Issue Number

6

Pages

531-538

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

Nephrology

Additional Departments

Hematology/Medical Oncology

PMID

31524721

DOI

10.1097/MCC.0000000000000657

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