Renal insufficiency after bone marrow transplantation in children. Bone Marrow Transplant 1991 May;7(5):383-8
Date
05/01/1991Pubmed ID
2070148Scopus ID
2-s2.0-0025772076 (requires institutional sign-in at Scopus site) 93 CitationsAbstract
Between 1975 and 1988, 92 pediatric patients have undergone bone marrow transplantation (BMT) at our institution for malignant or immune deficiency disease. We evaluated in a retrospective fashion 64 of these patients who survived beyond the first 60 days post-BMT. The clinical course was divided into: less than 60 days post-BMT (early) and greater than 60 days post-BMT (late). The presence or absence of renal insufficiency was noted as well as all known potential factors predisposing to insufficiency. Step-wise regression analysis was then performed to determine which of the factors were most significantly associated with renal dysfunction during the two periods. The follow-up period was 2 months to 11 years (mean 17.5 months). The mean age of the patients was 7.6 years (1 month-18 years). Fifty percent of the patients had renal insufficiency during the early period and 28% of the patients had insufficiency after the initial 60 days. Three major predictors of renal insufficiency were discovered. Cyclosporin A or amphotericin B early or late post-BMT was independently predictive of developing insufficiency during the same period. Conditioning with total body irradiation was a predictor for insufficiency in both periods. Early insufficiency was not predictive of late insufficiency. Hypertension was present in 31% of patients during the early period and in 16% during the late period. Hypertension was strongly associated with cyclosporin use and renal insufficiency. Renal insufficiency is a frequent sequela in children following BMT and likely results from a combination of radiation injury and drug toxicity.
Author List
Van Why SK, Friedman AL, Wei LJ, Hong RMESH terms used to index this publication - Major topics in bold
AdolescentAmphotericin B
Bone Marrow Transplantation
Child
Child, Preschool
Cyclosporins
Follow-Up Studies
Graft Rejection
Humans
Hypertension
Infant
Kidney Diseases
Regression Analysis
Retrospective Studies
