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Wednesday, November 21, 2012

Clinical Case 64: Answers and Summary


WHICH OF THESE LISTED ARE CAUSES OF ACUTE KIDNEY INJURY AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION?

Contrast dye
  8 (27%)
 
Sepsis
  13 (44%)
 
Tumor lysis syndrome
  12 (41%)
 
Veno occlusive disease
  15 (51%)
 
Thrombotic microangiopathy
  21 (72%)
 
Calcineurin toxicity
  13 (44%)
 

Causes of AKI after HSCT can be divided into two settings:
< 30 days: Sepsis, hypertension, pre renal, nephrotoxic agents, tumor  lysis syndrome( very early), veno occlusive disease(VOD). The nephrotoxic agents usually are: acyclovir, amp B, contrast agents, methotrexate, NSAIDs, allopurinol, ACEI/ARB, CNIs

> 30 days: Thrombotic microangiopathy and CNI toxicity

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