Chronic Kidney Disease Following Non‐Myeloablative Hematopoietic Cell Transplantation
Chronic kidney disease (CKD) following myeloablative allogeneic hematopoietic cell transplantation (HCT) occurs in 20% of survivors at 1 year and is believed to be due to radiation nephritis. Non‐myeloablative allogeneic HCT is a recent procedure that employs significantly lower doses of chemoradiot...
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| Veröffentlicht in: | American journal of transplantation 2006-01, Vol.6 (1), p.89-94 |
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| creator | Weiss, A. S. Sandmaier, B. M. Storer, B. Storb, R. McSweeney, P. A. Parikh, C. R. |
| description | Chronic kidney disease (CKD) following myeloablative allogeneic hematopoietic cell transplantation (HCT) occurs in 20% of survivors at 1 year and is believed to be due to radiation nephritis. Non‐myeloablative allogeneic HCT is a recent procedure that employs significantly lower doses of chemoradiotherapy, however, incidence and risk factors for CKD following non‐myleoablative HCT have not been defined.
We performed a retrospective cohort study of 122 patients from three institutions who were available for analysis at 6 months following non‐myeloablative HCT. Patients received two Gy of radiation; 62% received fludarabine as preconditioning. CKD was defined as at least a 25% reduction in glomerular filtration rate (GFR) from baseline using the abbreviated modified diet in renal disease (MDRD) equation.
Eighty‐one of 122 patients (66%) showed evidence of CKD at follow‐up. Multivariate analysis revealed that acute renal failure (ARF) during the first 100 days post‐transplant was associated with development of CKD (Adjusted OR 32.8 with 95% CI 4.3–250) after controlling for other variables. Previous autologous HCT, long‐term calcineurin inhibitor use and extensive chronic GVHD were independently associated with CKD.
CKD following non‐myeloablative HCT appears to be a distinct clinical entity and likely not related to radiation nephritis. Future research should focus on possible mechanisms for alleviating chronic injury and decreasing use of calcineurin inhibitors. |
| doi_str_mv | 10.1111/j.1600-6143.2005.01131.x |
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We performed a retrospective cohort study of 122 patients from three institutions who were available for analysis at 6 months following non‐myeloablative HCT. Patients received two Gy of radiation; 62% received fludarabine as preconditioning. CKD was defined as at least a 25% reduction in glomerular filtration rate (GFR) from baseline using the abbreviated modified diet in renal disease (MDRD) equation.
Eighty‐one of 122 patients (66%) showed evidence of CKD at follow‐up. Multivariate analysis revealed that acute renal failure (ARF) during the first 100 days post‐transplant was associated with development of CKD (Adjusted OR 32.8 with 95% CI 4.3–250) after controlling for other variables. Previous autologous HCT, long‐term calcineurin inhibitor use and extensive chronic GVHD were independently associated with CKD.
CKD following non‐myeloablative HCT appears to be a distinct clinical entity and likely not related to radiation nephritis. Future research should focus on possible mechanisms for alleviating chronic injury and decreasing use of calcineurin inhibitors.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/j.1600-6143.2005.01131.x</identifier><identifier>PMID: 16433761</identifier><language>eng</language><publisher>Oxford UK: Munksgaard International Publishers</publisher><subject>Acute renal failure ; Adolescent ; Adult ; Aged ; anemia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; bone marrow transplant ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Calcineurin Inhibitors ; Cohort Studies ; cyclosporine ; Female ; Hematopoietic Stem Cell Transplantation - adverse effects ; Humans ; hypertension ; Hypertension, Renal - epidemiology ; Hypertension, Renal - etiology ; Incidence ; Kidney - radiation effects ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - etiology ; Kidneys ; Male ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Urinary system involvement in other diseases. Miscellaneous</subject><ispartof>American journal of transplantation, 2006-01, Vol.6 (1), p.89-94</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3971-7371a53444abf1120f0c8903fb9870d0590811d5ebe9d4c394b98dc27f9400203</citedby><cites>FETCH-LOGICAL-c3971-7371a53444abf1120f0c8903fb9870d0590811d5ebe9d4c394b98dc27f9400203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1600-6143.2005.01131.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1600-6143.2005.01131.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,4010,27900,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17502574$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16433761$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weiss, A. S.</creatorcontrib><creatorcontrib>Sandmaier, B. M.</creatorcontrib><creatorcontrib>Storer, B.</creatorcontrib><creatorcontrib>Storb, R.</creatorcontrib><creatorcontrib>McSweeney, P. A.</creatorcontrib><creatorcontrib>Parikh, C. R.</creatorcontrib><title>Chronic Kidney Disease Following Non‐Myeloablative Hematopoietic Cell Transplantation</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>Chronic kidney disease (CKD) following myeloablative allogeneic hematopoietic cell transplantation (HCT) occurs in 20% of survivors at 1 year and is believed to be due to radiation nephritis. Non‐myeloablative allogeneic HCT is a recent procedure that employs significantly lower doses of chemoradiotherapy, however, incidence and risk factors for CKD following non‐myleoablative HCT have not been defined.
We performed a retrospective cohort study of 122 patients from three institutions who were available for analysis at 6 months following non‐myeloablative HCT. Patients received two Gy of radiation; 62% received fludarabine as preconditioning. CKD was defined as at least a 25% reduction in glomerular filtration rate (GFR) from baseline using the abbreviated modified diet in renal disease (MDRD) equation.
Eighty‐one of 122 patients (66%) showed evidence of CKD at follow‐up. Multivariate analysis revealed that acute renal failure (ARF) during the first 100 days post‐transplant was associated with development of CKD (Adjusted OR 32.8 with 95% CI 4.3–250) after controlling for other variables. Previous autologous HCT, long‐term calcineurin inhibitor use and extensive chronic GVHD were independently associated with CKD.
CKD following non‐myeloablative HCT appears to be a distinct clinical entity and likely not related to radiation nephritis. Future research should focus on possible mechanisms for alleviating chronic injury and decreasing use of calcineurin inhibitors.</description><subject>Acute renal failure</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>anemia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>bone marrow transplant</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Calcineurin Inhibitors</subject><subject>Cohort Studies</subject><subject>cyclosporine</subject><subject>Female</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Humans</subject><subject>hypertension</subject><subject>Hypertension, Renal - epidemiology</subject><subject>Hypertension, Renal - etiology</subject><subject>Incidence</subject><subject>Kidney - radiation effects</subject><subject>Kidney Failure, Chronic - epidemiology</subject><subject>Kidney Failure, Chronic - etiology</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkL9OwzAQhy0EglJ4BZQFtoa72KmTgaEqlH8FliJGy0kccOXGJU4p3XgEnpEnwaEVrNzik-77nU8fIQFCiL5OpyH2AXp9ZDSMAOIQECmG71uk8zvY_u1pvEf2nZsCII-SaJfsYZ9RyvvYIU_Dl9pWOg9udVGpVXCunZJOBSNrjF3q6jm4t9XXx-fdShkrMyMb_aaCKzWTjZ1brRofHSpjgkktKzc3smo8YqsDslNK49Th5u2Sx9HFZHjVGz9cXg8H415OU449TjnKmDLGZFYiRlBCnqRAyyxNOBQQp5AgFrHKVFown2F-UOQRL1MGEAHtkpP13nltXxfKNWKmXe4PkpWyCyc4cO8macFkDea1da5WpZjXeibrlUAQrVQxFa0v0boTrVTxI1W8--jR5o9FNlPFX3Bj0QPHG0C6XJrSq8i1--N4DFHMmefO1txSG7X69wFicDNpO_oNlxmShQ</recordid><startdate>200601</startdate><enddate>200601</enddate><creator>Weiss, A. S.</creator><creator>Sandmaier, B. M.</creator><creator>Storer, B.</creator><creator>Storb, R.</creator><creator>McSweeney, P. A.</creator><creator>Parikh, C. R.</creator><general>Munksgaard International Publishers</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200601</creationdate><title>Chronic Kidney Disease Following Non‐Myeloablative Hematopoietic Cell Transplantation</title><author>Weiss, A. S. ; Sandmaier, B. M. ; Storer, B. ; Storb, R. ; McSweeney, P. A. ; Parikh, C. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3971-7371a53444abf1120f0c8903fb9870d0590811d5ebe9d4c394b98dc27f9400203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Acute renal failure</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>anemia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>bone marrow transplant</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>Calcineurin Inhibitors</topic><topic>Cohort Studies</topic><topic>cyclosporine</topic><topic>Female</topic><topic>Hematopoietic Stem Cell Transplantation - adverse effects</topic><topic>Humans</topic><topic>hypertension</topic><topic>Hypertension, Renal - epidemiology</topic><topic>Hypertension, Renal - etiology</topic><topic>Incidence</topic><topic>Kidney - radiation effects</topic><topic>Kidney Failure, Chronic - epidemiology</topic><topic>Kidney Failure, Chronic - etiology</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weiss, A. S.</creatorcontrib><creatorcontrib>Sandmaier, B. M.</creatorcontrib><creatorcontrib>Storer, B.</creatorcontrib><creatorcontrib>Storb, R.</creatorcontrib><creatorcontrib>McSweeney, P. A.</creatorcontrib><creatorcontrib>Parikh, C. R.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weiss, A. S.</au><au>Sandmaier, B. M.</au><au>Storer, B.</au><au>Storb, R.</au><au>McSweeney, P. A.</au><au>Parikh, C. R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronic Kidney Disease Following Non‐Myeloablative Hematopoietic Cell Transplantation</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2006-01</date><risdate>2006</risdate><volume>6</volume><issue>1</issue><spage>89</spage><epage>94</epage><pages>89-94</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>Chronic kidney disease (CKD) following myeloablative allogeneic hematopoietic cell transplantation (HCT) occurs in 20% of survivors at 1 year and is believed to be due to radiation nephritis. Non‐myeloablative allogeneic HCT is a recent procedure that employs significantly lower doses of chemoradiotherapy, however, incidence and risk factors for CKD following non‐myleoablative HCT have not been defined.
We performed a retrospective cohort study of 122 patients from three institutions who were available for analysis at 6 months following non‐myeloablative HCT. Patients received two Gy of radiation; 62% received fludarabine as preconditioning. CKD was defined as at least a 25% reduction in glomerular filtration rate (GFR) from baseline using the abbreviated modified diet in renal disease (MDRD) equation.
Eighty‐one of 122 patients (66%) showed evidence of CKD at follow‐up. Multivariate analysis revealed that acute renal failure (ARF) during the first 100 days post‐transplant was associated with development of CKD (Adjusted OR 32.8 with 95% CI 4.3–250) after controlling for other variables. Previous autologous HCT, long‐term calcineurin inhibitor use and extensive chronic GVHD were independently associated with CKD.
CKD following non‐myeloablative HCT appears to be a distinct clinical entity and likely not related to radiation nephritis. Future research should focus on possible mechanisms for alleviating chronic injury and decreasing use of calcineurin inhibitors.</abstract><cop>Oxford UK</cop><pub>Munksgaard International Publishers</pub><pmid>16433761</pmid><doi>10.1111/j.1600-6143.2005.01131.x</doi><tpages>6</tpages></addata></record> |
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| ispartof | American journal of transplantation, 2006-01, Vol.6 (1), p.89-94 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Acute renal failure Adolescent Adult Aged anemia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences bone marrow transplant Bone marrow, stem cells transplantation. Graft versus host reaction Calcineurin Inhibitors Cohort Studies cyclosporine Female Hematopoietic Stem Cell Transplantation - adverse effects Humans hypertension Hypertension, Renal - epidemiology Hypertension, Renal - etiology Incidence Kidney - radiation effects Kidney Failure, Chronic - epidemiology Kidney Failure, Chronic - etiology Kidneys Male Medical sciences Middle Aged Nephrology. Urinary tract diseases Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Transfusions. Complications. Transfusion reactions. Cell and gene therapy Urinary system involvement in other diseases. Miscellaneous |
| title | Chronic Kidney Disease Following Non‐Myeloablative Hematopoietic Cell Transplantation |
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