Renal dysfunction in allogeneic hematopoietic cell transplantation

Kidney Int. 2002 Aug;62(2):566-73. doi: 10.1046/j.1523-1755.2002.00455.x.


Background: Allogeneic hematopoietic cell transplantation (HCT), formerly called bone marrow transplantation, can potentially cure various malignant and non-malignant diseases, but it is associated with a high risk of toxicity. We have previously shown an overall 21% incidence of severe acute renal failure in patients undergoing autologous HCT. The present study evaluated renal dysfunction in patients undergoing allogeneic HCT.

Methods: The clinical course of 88 adult patients who received allogeneic HCT at the University of Colorado Health Science Center was analyzed. Renal dysfunction was classified as follows: Grade 0 = normal renal function; Grade 1 =>25% decrement in GFR but <twofold rise in serum creatinine; Grade 2 =>twofold increase in serum creatinine; Grade 3 =>twofold increase in serum creatinine and need for dialysis.

Results: Of the 88 patients, 81 (92%) patients had some degree of renal dysfunction (Grade 1, 20 patients; Grade 2, 32 patients; Grade 3, 29 patients). Severe nephrotoxicity (Grade 2 and Grade 3 renal dysfunction) was associated with significantly higher frequencies of sepsis, hepatic toxicity and hepatic veno-occlusive disease (VOD), and lung toxicity. The overall mortality rate at the end of 6 months was 58%. Grade 3 renal dysfunction was associated with a significantly increased risk of mortality (82.6%).

Conclusion: A 92% incidence of renal dysfunction in allogeneic HCT patients was found. Lung and liver toxicities were significantly correlated with developing renal dysfunction, and the mortality rates for patients with Grade 3 renal failure exceeded 80%.

MeSH terms

  • Adult
  • Cyclosporine / adverse effects
  • Female
  • Glomerular Filtration Rate
  • Hematocrit
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hematopoietic Stem Cell Transplantation / mortality*
  • Hemoglobins
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Kidney Diseases / mortality*
  • Liver Diseases / mortality
  • Male
  • Middle Aged
  • Pancytopenia / mortality
  • Platelet Count
  • Retrospective Studies
  • Risk Factors
  • Transplantation, Homologous


  • Hemoglobins
  • Immunosuppressive Agents
  • Cyclosporine