bone marrow transplant (BMT) nephropathy

Etiology

• tumor lysis syndrome
• nephrotoxicity from bone marrow infusion (early)
• nephrotoxicity from amphotericin B
• sepsis
• hepatorenal-like syndrome
  • occurs 10-16 days after BMT
  • endothelial injury from chemotherapy &/or radiation
  • volume overload
  • urine [Na+] < 40 meq/L
  • pre-existing renal &/or hepatic disease are risk factors
• signs & symptoms of hemolytic-uremic syndrome (HUS)
  • 4-12 months after BMT
  • hypertension
  • renal insufficiency
  • proteinuria
  • hematuria
  • erythrocyte casts in urine
  • signs of microangiopathic hemolytic anemia
  • thrombocytopenia
  • central nervous system dysfunction
  • cyclosporin & total body radiation may play a role in the pathogenesis
• radiation nephropathy
• nephrotoxic chemotherapy & immunosuppressive agents may exacerbate renal disease

Epidemiology

common in some centers

Management

• therapy is supportive: dialysis may be necessary

More general terms

• nephropathy

Additional terms

• bone marrow transplantation (BMT)
• hemolytic uremic syndrome (HUS)
• hepatorenal syndrome; acute kidney injury in cirrhosis
• tumor lysis syndrome