医学
造血干细胞
干细胞
肾脏疾病
疾病
造血干细胞移植
造血
造血细胞
肾
内科学
肿瘤科
遗传学
生物
作者
Yu Zhang,Weiwei Fu,Xianghua Huang
出处
期刊:PubMed
日期:2025-07-17
摘要
Hematopoietic stem cell transplant (HSCT) is a well-established procedure for malignant and nonmalignant conditions. Despite its therapeutic benefits, kidney disease remains a common complication that significantly impacts patient outcomes. Kidney injury post-HSCT manifests as acute kidney injury (AKI) and chronic kidney disease (CKD), with multifactorial causes such as conditioning regimens, nephrotoxic drugs, graft-versus-host disease (GVHD), and transplant-associated thrombotic microangiopathy (TA-TMA). Accurate diagnosis often requires a kidney biopsy due to overlapping risk factors and complex clinical presentations. This review summarizes current diagnostic and therapeutic standards, highlights advance in biomarkers and pathophysiology, and discusses targeted therapies such as rituximab for GVHD-related glomerulopathies and eculizumab for TA-TMA. Supportive care, immunomodulation, and early intervention remain critical. For patients progressing to end stage renal disease, renal replacement therapy and kidney transplantation post-HSCT offer viable long-term options. Despite these advances, challenges persist, including the need for noninvasive diagnostic tools and standardized management protocols. Future research into pathophysiology, biomarkers, and targeted therapies holds promise for improving outcomes in this field.
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