Experimental Biology 2010: A Comparison Of Kidney Dysfunction And Hypertension In Allogeneic And Autologous Hematopoietic Cell Transplant Recipients

Purpose of Study: An increased risk of chronic kidney disease (CKD) is a well known complication of hematopoietic cell transplantation (HCT). The purpose of this study was to compare the frequency and severity of renal dysfunction, as well as the prevalence of proteinuria and new-onset hypertension (HTN), in allogeneic and autologous HCT recipients during the first two years post-transplant.

Methods Used: We undertook a prospective, cohort study of consecutive patients who underwent allogeneic and autologous HCT at a large single center over one year. Our primary endpoints were degree of decline in GFR and development of microalbuminuria, proteinuria and hypertension (HTN).

Summary of Results: 58 patients receiving an allogeneic transplant and 41 with an autologous were enrolled. Overall, 25 (43%) of allogeneic and 6 (17%) of autologous patients developed a 25mL/min decline in GFR and 41 (71%) and 19 (46%) showed a decline of at least 10 mL/min (Figure 1). By 24 months, both groups exhibited significant increases in the percentage of patients with HTN. There was no significant increase throughout follow-up in the degree of mean proteinuria in either group from baseline nor was there a consistent difference between groups in the development of HTN.

Conclusions: The majority of patients showed accelerated decline in kidney function with both HCT procedures. This renal dysfunction is non-proteinuric but is accompanied by increased HTN. Allogeneic HCT is associated with a higher risk for loss of kidney function and CKD compared to autologous HCT.