Monday, January 10, 2011
IN THE NEWS --> Cytoresistance and the kidney
In the recent CJASN issue of Jan 2011, a clinical paper of this entity was reported in the post BMT patients with renal injury. We know that Bone marrow nephropathy exists and there was multiple causes for it. Close to >3000 cases were reviewed and the groups with >25% drop in GFR were assessed and then the absolute loss of GFR was noted. Interestingly, they noted that the higher the baseline eGFR, the greater the risk and severity of subsequent loss of renal function with statistical P value. So if you had lower GFR to start with, there was "cytoresistance" to further renal damage.
This is an interesting concept. This is a retrospective review, only bone marrow transplant patients, they get a lot of immunomodulatory agents, including radiation, T cell depletion sometimes, and the eGFR was only one value after a year. When immunemodulatory agents are involved, don't know how we can really evaluate this concept. Perhaps a broader renal injury ( cardiac surgery, ATN sepsis) should be evaluate to see if this concept holds.
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