Authors: Sangeeta Hingorani
Publish Date: 2008/04/15
Volume: 23, Issue: 6, Pages: 879-
Abstract
Patient survival after cardiac liver and hematopoietic stem cell transplant HSCT is improving however this survival is limited by substantial pretransplant and treatmentrelated toxicities A major cause of morbidity and mortality after transplant is chronic kidney disease CKD Although the majority of CKD after transplant is attributed to the use of calcineurin inhibitors various other conditions such as thrombotic microangiopathy nephrotic syndrome and focal segmental glomerulosclerosis have been described Though the immunosuppression used for each of the transplant types cardiac liver and HSCT is similar the risk factors for developing CKD and the CKD severity described in patients after transplant vary As the indications for transplant and the longterm survival improves for these children so will the burden of CKD Nephrologists should be involved early in the pretransplant workup of these patients Transplant physicians and nephrologists will need to work together to identify those patients at risk of developing CKD early to prevent its development and progression to endstage renal disease
Keywords: