Kidney Disease Associated with Hematopoietic Stem Cell Transplant

Hematopoietic stem cell transplantation in the USA is growing, and stem cell transplant recipients are at risk for both acute and chronic renal injury. Some etiologies of acute kidney injury are shared with the general population, such as prerenal azotemia and acute tubular necrosis, while others are unique to aspects of the stem cell procedure and include hepatic veno-occlusive disease and BK cystitis. Long-term hematopoietic stem cell transplant survivors are also at increased risk for chronic kidney disease, and important etiologies include calcineurin inhibitor toxicity, nephrotic syndrome, and thrombotic microangiopathy. Stem cell transplant patient survival on chronic dialysis is poor, but well-selected patients can have excellent outcomes with renal transplantation.