Long-term renal function after hemopoietic stem cell transplantation in children

Glomerular function of all long-term survivors who underwent hemopoietic stem cell transplantation (HSCT) from 1991 to 1998 ( study I, n = 121) was studied retrospectively. In addition, we prospectively analyzed glomerular and tubular function of all long-term surviving children who received an HSCT between 1998 and 2000 (study II, n = 41). We found a lower prevalence of children with chronic renal failure (CRF) post-HSCT in our more recent cohort ( study II: 10%) as compared to the older cohort ( study I: 24%) 5.0 (0.7 s. d.) and 7.6 (2.4 s. d.) year's post-HSCT, respectively. Furthermore, it seems that renal function may stabilize after 1-year post-HSCT. None of the patients required dialysis or antihypertensive medication at long-term follow-up. The sole predictor of CRF in our study was high serum creatinine pre-HSCT ( P = 0.007), while acute renal failure within 3 months after HSCT ( P = 0.08) only showed a trend towards predicting CRF. We could not confirm a relation of conditioning with irradiation with CRF post-HSCT, as was shown in several other pediatric and adult studies. Proximal and distal tubular dysfunction only occurred in a minority of long-time survivors of HSCT ( 3 - 12 and 9 - 13%, respectively) and had no clinical consequences.