De Novo Postallogeneic Hematopoietic Stem Cell Transplant Membranous Nephropathy

Numata, Akihiko; Morishita, Yoshiyuki; Mori, Masaki; Saito, Osamu; Ando, Yumiko; Muto, Shigeaki; Yumura, Wako; Kusano, Eiji

doi:10.6002/ect.2012.0078

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…[5][6][7] In MCD, T cell activation may be the cause of cytokine and antibody-mediated injury and can occur without other signs of GVHD, as evidenced in our patient. 8,9 The largest series of NS after GVHD was published by Reddy et al 10 who followed 889 patients and evaluated who developed non-cardiac edema with only 9 patients (0.9%) having evidence of NS. The median age was 54 years, and all patients received PBSCT with some evidence of HLA mismatch with no one having any pre-existing renal conditions.…”

Section: Discussionmentioning

confidence: 99%

Minimal change disease after hematopoietic stem cell transplant: Manifestation of chronic graft-versus-host disease

Padhi

Muchayi

Teske³

et al. 2019

Journal of Onco-Nephrology

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Chronic graft-versus-host disease is a potentially life-threatening immunological complication which can occur any time after hematopoietic stem cell transplant. Many organ systems can be affected; however, kidneys are normally not and development of nephrotic syndrome is particularly rare. In our report, a 64 year old who was diagnosed with acute myelogenous leukemia developed acute kidney injury and nephrotic syndrome secondary to minimal change disease. The patient responded well to treatment with steroids and rituximab therapy. Our goal is to communicate that nephrotic syndrome should be suspected in patients with significant hypoalbuminemia after graft-versus-host disease and withdrawing immunosuppression.

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Section: Discussionmentioning

confidence: 99%

Minimal change disease after hematopoietic stem cell transplant: Manifestation of chronic graft-versus-host disease

Padhi

Muchayi

Teske³

et al. 2019

Journal of Onco-Nephrology

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“…When the nephrotic syndrome appears after hematopoietic-cell transplantation, it usually occurs in the context of chronic and protracted acute GVHD, after the dose of immunosuppressive medication has been tapered; few cases occur in the absence of GVHD. [61][62][63] Minimal-change nephrotic syndrome after hematopoietic-cell transplantation, which is considered to be a T-cell-mediated process, has also been described, sometimes in the absence of overt GVHD elsewhere in the body. [61][62][63][64] Elevated serum levels of interferon-γ and tumor necrosis factor-α have been reported, and in one case, anti-phospholipase A 2 receptor antibodies were present; these findings suggest a role for both cytokine-and antibody-mediated injury.…”

Section: The Nephrotic Syndromementioning

confidence: 99%

“…[61][62][63] Minimal-change nephrotic syndrome after hematopoietic-cell transplantation, which is considered to be a T-cell-mediated process, has also been described, sometimes in the absence of overt GVHD elsewhere in the body. [61][62][63][64] Elevated serum levels of interferon-γ and tumor necrosis factor-α have been reported, and in one case, anti-phospholipase A 2 receptor antibodies were present; these findings suggest a role for both cytokine-and antibody-mediated injury. 59,60,65 Case reports of membranoproliferative glomerulonephritis, class III lupus nephritis, focal segmental glomerulosclerosis, and IgA nephropathy in transplant recipients have also been published.…”

Section: The Nephrotic Syndromementioning

confidence: 99%

Renal Complications of Hematopoietic-Cell Transplantation

Hingorani¹

2016

N Engl J Med

173

177

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ach year, approximately 50,000 patients worldwide undergo hematopoietic-cell transplantation. This procedure, which is used to treat a wide range of malignant and nonmalignant diseases, may involve either a myeloablative or reduced-intensity conditioning regimen; the use of alternative allogeneic donors (i.e., haploidentical or mismatched donors); cells from bone marrow, cord blood, or peripheral-blood stem cells; and new immunomodulatory agents to prevent graft-versus-host disease (GVHD) 1 (Table 1). Despite the overall improvement in outcomes after hematopoietic-cell transplantation, kidney injury remains a frequent complication and contributes to the morbidity and mortality associated with the procedure. 2-11 The onset of acute kidney injury and chronic kidney disease, which affect from 10 to 70% of transplant recipients, 2,7,12,13 varies from days after transplantation to months or years afterward. Acute injury is generally indicated by elevated levels of serum creatinine up to 100 days after transplantation, and chronic injury by elevated levels at or after 100 days. Acute kidney injury that persists for 3 months or longer is usually reclassified as chronic kidney disease. The overall health of the patient at the time of transplantation is generally assessed with use of a hematopoietic-cell transplantation-specific comorbidity index that includes the serum creatinine level. 14 In this index, which includes 17 categories of organ dysfunction, scores for organ-specific coexisting conditions range from 0 to 3, with higher scores indicating a greater severity of the condition. The risk categories are not fixed and can vary according to conditioning regimens. Scores on the comorbidity index range from 0 to 12. Higher scores on the index (the weighted sum of all the scores for organ-specific conditions and other pretransplantation characteristics) indicate a greater risk of death that is not associated with relapse. In general, patients with a score of 0 are considered to be at low risk of death that is not associated with relapse, those with a score of 1 or 2 are considered to be at intermediate risk, and those with a score of 3 or greater are considered to be at high risk. A score of 1 or more is correlated with a risk of acute post-transplantation kidney injury. 3 Such kidney injury may be caused by conditioning chemotherapy, total-body irradiation, nephrotoxic agents, infections, the hepatic sinusoidal obstruction syndrome (previously called veno-occlusive disease of the liver), transplantation-associated thrombotic microangiopathy, and GVHD. 3-7,15-19 This article reviews the causes, diagnosis, and management of complications and disorders of the kidney after hematopoietic-cell transplantation. Definition a nd Epidemiol ogy of K idne y Injur y Acute kidney injury after transplantation was initially defined as a doubling of the baseline serum creatinine level within the first 100 days after transplantation.

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“…There has also been a frequent association of post-HCT MN with chronic GVHD, presenting as early as 2 months after transplantation, but more typically appearing 6 – 12 months later [69]. Very few cases of nephrotic syndrome after HCT have been reported in the absence of GVHD [50, 70, 71, 72].…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

Mini-review of kidney disease following hematopoietic stem cell transplant

Sedhom¹,

Sedhom²,

Jaimes³

2018

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Advancements in hematopoietic cell transplantation (HCT) have broadened indications for its use and resulted in more long-term survivors. Stem cell transplantation is associated with several well-known toxicities, although renal complications are not well defined. Acute and chronic kidney disease remains a common complication following transplantation itself. Incidence and risk factors for the development of chronic kidney disease (CKD) is less well understood. Recent estimates suggest that nearly 15% of subjects undergoing HCT will develop CKD, a complication that can progress to end-stage renal disease (ESRD), disrupts overall quality of life, and reduces overall survival. Several commonly-reported risk factors include acute kidney injury, graft-versus-host disease, and long-term calcineurin inhibitor use. This review highlights the incidence, timeline, etiology, risk factors, and prognosis of kidney disease in the setting of hematopoietic stem cell transplantation. Investigation of the causes of CKD is needed, as are ways to prevent, mitigate, and treat kidney injury. Renal disease importantly reflects prognosis, with dialysis-requiring patients carrying greater than 80% mortality after 3 years. Although CKD following HCT is common, prospective studies are needed to confirm risk factors and better define the underlying mechanisms in order to promote therapies that prevent this complication. .

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De Novo Postallogeneic Hematopoietic Stem Cell Transplant Membranous Nephropathy

Cited by 7 publications

References 16 publications

Minimal change disease after hematopoietic stem cell transplant: Manifestation of chronic graft-versus-host disease

Minimal change disease after hematopoietic stem cell transplant: Manifestation of chronic graft-versus-host disease

Renal Complications of Hematopoietic-Cell Transplantation

Mini-review of kidney disease following hematopoietic stem cell transplant

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