Hematopoietic cell transplantation (HCT) is an increasingly common treatment for many malignancies. Each type of HCT carries its own risks and complications. The most common chronic complications are calcinurine inhibitors (CsA) toxicities, development of chronic graft versus host disease (GVHD). Occurrence of chronic renal disorders after HCT is rare and only a few cases have been reported. Renal damage can be induced by several conditions such as total-body irradiation (TBI), CsA and other nephrotoxic agents, and also because of graft versus host diseases. The aim of this study was to evaluate the occurrence of nephrotic syndrome after HCT. To evaluate the frequency of nephrotic syndrome one thousand six hundred ninety three recipients of HCT were evaluated between 1997and 2006 at the Bone Marrow Transplant Research Center, Shariati hospital,Tehran-Iran. Patients were followed prospectively after three months of transplant. Nephrotic syndrome was defined as proteinuria more than 3gr/24hr urine, at any time after three months of the post-transplant period. The risk of nephrotic syndrome in relation to non based total body irradiation conditioning regimen, type of graft (allograft, autograft) and co morbidity, GVHD, drug toxicity was examined in 1693 HCT patients. Nephrotic syndrome occurred in 15% of patients 10 patients with a biopsy proven glomerular involvement, mostly had membranous glomerolunephritis (MGN) (7 cases), membranoproliferative glomerolunephritis MPGN (1 case), sandimmune toxicity (1 case), minimal change disease (1case). The predominant underlying diagnosis were, CML (3 cases), AA (2 cases) AML (3 cases) and ALL (2 cases). Nephrotic syndrome was the most common abnormality (9of 66 patients) after allograft HCT, with a mean of 18 months. In conclusion, a higher frequency was observed in patients who received allograft HCT. The presence of GVHD increased the risk of nephrotic syndrome after three months of HCT.
Volume : 6
Issue : 4
Pages : 221
Nephrology and Bone Marrow Transplant Research Center, Shariati Hospital , Tehran University Of Medical Sciences, Tehran , Iran