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Article: Clinico-pathological correlations and outcomes of de novo glomerular diseases in patients after haematopoietic stem cell transplantation
| Title | Clinico-pathological correlations and outcomes of <i>de novo</i> glomerular diseases in patients after haematopoietic stem cell transplantation |
|---|---|
| Authors | |
| Issue Date | 10-Dec-2022 |
| Publisher | Oxford University Press |
| Citation | Clinical Kidney Journal, 2023, v. 16, n. 6, p. 976-984 How to Cite? |
| Abstract | Background Various glomerular pathologies have been reported in patients who have undergone haematopoietic stem cell transplantation (HSCT), but the data on clinico-pathological correlations and clinical outcome remain limited. Methods We analysed the clinical and histopathological data of patients who had biopsy-proven de novo glomerular diseases after HSCT since 1999. Results A total of 2204 patients underwent HSCT during the period 1999–2021, and 31 patients (1.4%) developed de novo glomerular diseases after a mean duration of 2.8 ± 2.7 years after HSCT. Fifteen of these patients (48.4%) had graft-versus-host-disease prior to or concomitant with renal abnormalities. Proteinuria and eGFR at the time of kidney biopsy were 4.1 ± 5.3 g/day and 50.8 ± 25.4 mL/min/1.73 m2, respectively. Kidney histopathologic diagnoses included thrombotic microangiopathy (TMA) (38.7%), membranous nephropathy (MN) (25.8%), mesangial proliferative glomerulonephritis (12.9%), minimal change disease (9.7%), focal segmental glomerulosclerosis (9.7%) and membranoproliferative glomerulonephritis (3.2%). Immunosuppressive treatment was given to patients who presented with nephrotic-range proteinuria and/or acute kidney injury, while renin–angiotensin–aldosterone blockade was given to all patients with proteinuria ≥1 g/day, with complete and partial response rates of 54.8% and 19.4%, respectively. One patient with TMA progressed to end-stage kidney disease after 24 weeks, and two patients, one with TMA and one with MN, (6.4%) progressed to chronic kidney disease (CKD) Stage ≥3. Kidney and patient survival rates were 96.6% and 83.5%, respectively, at 5 years. Conclusion De novo glomerular diseases with diverse histopathologic manifestations affect 1.4% of patients after HSCT, and approximately 10% develop progressive CKD. |
| Persistent Identifier | http://hdl.handle.net/10722/329052 |
| ISSN | 2021 Impact Factor: 5.860 2020 SCImago Journal Rankings: 1.033 |
| DC Field | Value | Language |
|---|---|---|
| dc.contributor.author | Yap, DYH | - |
| dc.contributor.author | Lie, D | - |
| dc.contributor.author | Lau, T | - |
| dc.contributor.author | Tang, A | - |
| dc.contributor.author | Chan, G | - |
| dc.contributor.author | Chan, TSY | - |
| dc.contributor.author | Sim, J | - |
| dc.contributor.author | Lie, AKW | - |
| dc.contributor.author | Chan, TM | - |
| dc.date.accessioned | 2023-08-05T07:54:55Z | - |
| dc.date.available | 2023-08-05T07:54:55Z | - |
| dc.date.issued | 2022-12-10 | - |
| dc.identifier.citation | Clinical Kidney Journal, 2023, v. 16, n. 6, p. 976-984 | - |
| dc.identifier.issn | 2048-8505 | - |
| dc.identifier.uri | http://hdl.handle.net/10722/329052 | - |
| dc.description.abstract | <p>Background</p><p>Various glomerular pathologies have been reported in patients who have undergone haematopoietic stem cell transplantation (HSCT), but the data on clinico-pathological correlations and clinical outcome remain limited.</p><p>Methods</p><p>We analysed the clinical and histopathological data of patients who had biopsy-proven <em>de novo</em> glomerular diseases after HSCT since 1999.</p><p>Results</p><p>A total of 2204 patients underwent HSCT during the period 1999–2021, and 31 patients (1.4%) developed <em>de novo</em> glomerular diseases after a mean duration of 2.8 ± 2.7 years after HSCT. Fifteen of these patients (48.4%) had graft-versus-host-disease prior to or concomitant with renal abnormalities. Proteinuria and eGFR at the time of kidney biopsy were 4.1 ± 5.3 g/day and 50.8 ± 25.4 mL/min/1.73 m<sup>2</sup>, respectively. Kidney histopathologic diagnoses included thrombotic microangiopathy (TMA) (38.7%), membranous nephropathy (MN) (25.8%), mesangial proliferative glomerulonephritis (12.9%), minimal change disease (9.7%), focal segmental glomerulosclerosis (9.7%) and membranoproliferative glomerulonephritis (3.2%). Immunosuppressive treatment was given to patients who presented with nephrotic-range proteinuria and/or acute kidney injury, while renin–angiotensin–aldosterone blockade was given to all patients with proteinuria ≥1 g/day, with complete and partial response rates of 54.8% and 19.4%, respectively. One patient with TMA progressed to end-stage kidney disease after 24 weeks, and two patients, one with TMA and one with MN, (6.4%) progressed to chronic kidney disease (CKD) Stage ≥3. Kidney and patient survival rates were 96.6% and 83.5%, respectively, at 5 years.</p><p>Conclusion</p><p><em>De novo</em> glomerular diseases with diverse histopathologic manifestations affect 1.4% of patients after HSCT, and approximately 10% develop progressive CKD.</p> | - |
| dc.language | eng | - |
| dc.publisher | Oxford University Press | - |
| dc.relation.ispartof | Clinical Kidney Journal | - |
| dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
| dc.title | Clinico-pathological correlations and outcomes of <i>de novo</i> glomerular diseases in patients after haematopoietic stem cell transplantation | - |
| dc.type | Article | - |
| dc.identifier.doi | 10.1093/ckj/sfac264 | - |
| dc.identifier.volume | 16 | - |
| dc.identifier.issue | 6 | - |
| dc.identifier.spage | 976 | - |
| dc.identifier.epage | 984 | - |
| dc.identifier.eissn | 2048-8513 | - |
| dc.identifier.issnl | 2048-8505 | - |