One of the devastating complications of bone marrow transplants is veno occlusive disease(VOD) characterized by weight gain, painful hepatomegaly, ascites, jaundice, bilirubin levels astronomically high. This usually happens 30 days following the transplant.
VOD associated AKI is clinically not different from Hepato renal syndrome. Patients usually have a a pre renal picture with oliguria, low FENa and clinically appear volume overloaded. Patients are either hypotensive or normotensive and hyponatremia might be present. Hence looks very similar to a cirrhotic patient with acute renal injury. Tubular damage can be seen with granular casts in advanced disease and perhaps some component of pigment(bilirubin) nephropathy. When kidney biopsies are done in the patients, there are no structural damages noted unless ATN has ensued. Hence, the pathophysiology is similar to hepatorenal syndrome essentially.
Makes the injury mostly volume related or hemodynamic in nature or a "false" permanent activation of renin angiotensin system: like hepato renal syndrome
Cancer and the Kidney, Second edition, Eric Cohen
- ► 2021 (36)
- ► 2020 (32)
- ► 2019 (42)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- Geriatric Nephrology
- TOPIC DISCUSSION: Ageusia and ACEI/ARBS
- Nephrology Quiz at UKidney.com
- Disorders of Sodium & Water Balance: A mathematic...
- IN THE NEWS- Idiopathic Membranous GN and HLA-DQA1
- Skin cancer and Transplants
- TOPIC DISCUSSION: Is Veno-occlusive disease associ...
- JOURNAL CLUB: ESCAPE TRIAL
- Nephrology Anagrams
- TOPIC DISCUSSION: Renal Vein Pressures and Cardio ...
- World Kidney day
- CLINICAL CASE 33, ANSWER AND SUMMARY(IMAGE QUIZ)
- Suggest and Vote for New Ideas in Nephrology
- Risk factors for post transplant Hypertension
- TOPIC DISCUSSION: Pseudohyperphosphatemia
- TOPIC DISCUSSION: Hypercalcemia of Malignancy
- JOURNAL CLUB: BELATACEPT and Transplantation
- TOPIC DISCUSSION: Lactic acidosis and Dialysis?
- Male Fertility and Transplantation
- TOPIC DISCUSSION: Membranous and Class Type IgG
- Renal Blog in finalist for Best Medical Blog( Clin...
- TOPIC DISCUSSION: Spontaneous Perinephric Hemorrhage
- Nephsap review: Transplantation
- Acute Kidney Injury in Cancer Patients
- CLINICAL CASE 32, ANSWERS AND SUMMARY
- ▼ February (25)
- ► 2010 (461)