Clinical Case 64: Answers and Summary

WHICH OF THESE LISTED ARE CAUSES OF ACUTE KIDNEY INJURY AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION?

Contrast dye

  8 (27%)

 

Sepsis

  13 (44%)

 

Tumor lysis syndrome

  12 (41%)

 

Veno occlusive disease

  15 (51%)

 

Thrombotic microangiopathy

  21 (72%)

 

Calcineurin toxicity

  13 (44%)

 

Causes of AKI after HSCT can be divided into two settings:

< 30 days: Sepsis, hypertension, pre renal, nephrotoxic agents, tumor  lysis syndrome( very early), veno occlusive disease(VOD). The nephrotoxic agents usually are: acyclovir, amp B, contrast agents, methotrexate, NSAIDs, allopurinol, ACEI/ARB, CNIs

> 30 days: Thrombotic microangiopathy and CNI toxicity