Clinical Manifestations and Prognosis of Chronic Kidney Disease after Hematopoietic Stem Cell Transplantation

Introduction: Kidney disease is a common complication of hematopoietic stem cell transplantation (HSCT). However, there is limited research on the clinical pathology and prognosis of patients who develop chronic kidney disease (CKD) after HSCT. Methods: A retrospective analysis was conduc...

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Main Authors: Yu Zhang, Guisheng Ren, Wencui Chen, Jinzhou Guo, Xiaomei Wu, Weiwei Xu, Xianghua Huang
Format: Article
Language:English
Published: Karger Publishers 2025-01-01
Series:Kidney Diseases
Online Access:https://karger.com/article/doi/10.1159/000545198
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author Yu Zhang
Guisheng Ren
Wencui Chen
Jinzhou Guo
Xiaomei Wu
Weiwei Xu
Xianghua Huang
author_facet Yu Zhang
Guisheng Ren
Wencui Chen
Jinzhou Guo
Xiaomei Wu
Weiwei Xu
Xianghua Huang
author_sort Yu Zhang
collection DOAJ
description Introduction: Kidney disease is a common complication of hematopoietic stem cell transplantation (HSCT). However, there is limited research on the clinical pathology and prognosis of patients who develop chronic kidney disease (CKD) after HSCT. Methods: A retrospective analysis was conducted on 50 patients diagnosed with CKD through kidney biopsy between September 2008 and May 2024. The patients were categorized based on their pathological presentations into groups with thrombotic microangiopathy (TMA) or membranous nephropathy (MN). Results: The renal pathological results revealed that TMA was the most prevalent pathological type, accounting for 40% of cases, followed by MN at 32%, and mesangial proliferative glomerulonephritis at 16%, among others. Clinically, patients with TMA predominantly presented with renal insufficiency, whereas those with MN mainly exhibited nephrotic syndrome. Patients with MN showed favorable responses to treatment, achieving complete and partial response rates of 14.3% and 71.4%, respectively. Among the 50-patient cohort, 45 remained alive, corresponding to a 5-year overall survival rate of 87.8%. The 5-year renal survival rate was observed to be 78.8%, with 3 patients (6.98%) requiring kidney replacement therapy. Conclusion: TMA and MN are the two most common pathological findings in patients with CKD following HSCT. Both conditions exhibit favorable responses to combined steroids and immunosuppressant therapy. Notably, patients with MN demonstrate a higher overall response rate and superior treatment outcomes compared to those with TMA.
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spelling doaj-art-2b6d07a6ca8a451798e670ee01933f792025-08-20T03:49:41ZengKarger PublishersKidney Diseases2296-93572025-01-0111119520510.1159/000545198Clinical Manifestations and Prognosis of Chronic Kidney Disease after Hematopoietic Stem Cell TransplantationYu ZhangGuisheng RenWencui ChenJinzhou GuoXiaomei WuWeiwei XuXianghua Huang Introduction: Kidney disease is a common complication of hematopoietic stem cell transplantation (HSCT). However, there is limited research on the clinical pathology and prognosis of patients who develop chronic kidney disease (CKD) after HSCT. Methods: A retrospective analysis was conducted on 50 patients diagnosed with CKD through kidney biopsy between September 2008 and May 2024. The patients were categorized based on their pathological presentations into groups with thrombotic microangiopathy (TMA) or membranous nephropathy (MN). Results: The renal pathological results revealed that TMA was the most prevalent pathological type, accounting for 40% of cases, followed by MN at 32%, and mesangial proliferative glomerulonephritis at 16%, among others. Clinically, patients with TMA predominantly presented with renal insufficiency, whereas those with MN mainly exhibited nephrotic syndrome. Patients with MN showed favorable responses to treatment, achieving complete and partial response rates of 14.3% and 71.4%, respectively. Among the 50-patient cohort, 45 remained alive, corresponding to a 5-year overall survival rate of 87.8%. The 5-year renal survival rate was observed to be 78.8%, with 3 patients (6.98%) requiring kidney replacement therapy. Conclusion: TMA and MN are the two most common pathological findings in patients with CKD following HSCT. Both conditions exhibit favorable responses to combined steroids and immunosuppressant therapy. Notably, patients with MN demonstrate a higher overall response rate and superior treatment outcomes compared to those with TMA. https://karger.com/article/doi/10.1159/000545198
spellingShingle Yu Zhang
Guisheng Ren
Wencui Chen
Jinzhou Guo
Xiaomei Wu
Weiwei Xu
Xianghua Huang
Clinical Manifestations and Prognosis of Chronic Kidney Disease after Hematopoietic Stem Cell Transplantation
Kidney Diseases
title Clinical Manifestations and Prognosis of Chronic Kidney Disease after Hematopoietic Stem Cell Transplantation
title_full Clinical Manifestations and Prognosis of Chronic Kidney Disease after Hematopoietic Stem Cell Transplantation
title_fullStr Clinical Manifestations and Prognosis of Chronic Kidney Disease after Hematopoietic Stem Cell Transplantation
title_full_unstemmed Clinical Manifestations and Prognosis of Chronic Kidney Disease after Hematopoietic Stem Cell Transplantation
title_short Clinical Manifestations and Prognosis of Chronic Kidney Disease after Hematopoietic Stem Cell Transplantation
title_sort clinical manifestations and prognosis of chronic kidney disease after hematopoietic stem cell transplantation
url https://karger.com/article/doi/10.1159/000545198
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