PDF(Pubmed)
Abstract：
UNASSIGNED: The incidence of kidney disease is high in patients after allogeneic hematopoietic cell transplantation (aHCT). Although rarely performed, kidney biopsy may be useful to make a precise diagnosis because several mechanisms and risk factors can be involved, and to adjust the treatment accordingly. This case series aimed to report the spectrum of biopsy findings from patients with kidney injury after aHCT.
UNASSIGNED: Single-center retrospective case series.
UNASSIGNED: All individuals who underwent a native kidney biopsy, among all adult patients who received aHCT in a tertiary hospital in Montreal (Canada) from January 1, 2010, to December 31, 2020, were identified, and the clinical data were extracted from their medical records.
UNASSIGNED: A total of 17 patients were included. Indications for biopsy included acute kidney injury (n=6), chronic kidney disease (n=5), nephrotic syndrome (n=4), and subnephrotic proteinuria (n=2). Pathologic findings from the kidney biopsy were heterogenous: 10 patients showed evidence of thrombotic microangiopathy (TMA), 5 of acute tubular injury, and 4 of membranous nephropathy. Cases of acute interstitial nephritis, BK virus nephropathy, immune complex nephropathy, focal and segmental glomerulosclerosis, minimal change disease, and karyomegalic-like interstitial nephritis were also described.
UNASSIGNED: There was no systematic kidney biopsy performed for all patients with kidney injury after aHCT. Only a small proportion of patients with kidney damage underwent biopsy, making the results less generalizable.
UNASSIGNED: Kidney biopsy is useful in patients with kidney disease after aHCT to make a precise diagnosis and tailor therapy accordingly. This series is one of the few published studies describing pathologic findings of biopsies performed after aHCT in the context of acute kidney injury and chronic kidney disease. TMA was widely present on biopsy even when there was no clinical suspicion of such a diagnosis, suggesting that the current clinical criteria for a diagnosis of TMA are not sensitive enough for kidney-limited TMA.
UNASSIGNED: Single-center retrospective case series.
UNASSIGNED: All individuals who underwent a native kidney biopsy, among all adult patients who received aHCT in a tertiary hospital in Montreal (Canada) from January 1, 2010, to December 31, 2020, were identified, and the clinical data were extracted from their medical records.
UNASSIGNED: A total of 17 patients were included. Indications for biopsy included acute kidney injury (n=6), chronic kidney disease (n=5), nephrotic syndrome (n=4), and subnephrotic proteinuria (n=2). Pathologic findings from the kidney biopsy were heterogenous: 10 patients showed evidence of thrombotic microangiopathy (TMA), 5 of acute tubular injury, and 4 of membranous nephropathy. Cases of acute interstitial nephritis, BK virus nephropathy, immune complex nephropathy, focal and segmental glomerulosclerosis, minimal change disease, and karyomegalic-like interstitial nephritis were also described.
UNASSIGNED: There was no systematic kidney biopsy performed for all patients with kidney injury after aHCT. Only a small proportion of patients with kidney damage underwent biopsy, making the results less generalizable.
UNASSIGNED: Kidney biopsy is useful in patients with kidney disease after aHCT to make a precise diagnosis and tailor therapy accordingly. This series is one of the few published studies describing pathologic findings of biopsies performed after aHCT in the context of acute kidney injury and chronic kidney disease. TMA was widely present on biopsy even when there was no clinical suspicion of such a diagnosis, suggesting that the current clinical criteria for a diagnosis of TMA are not sensitive enough for kidney-limited TMA.
摘要：
■异基因造血细胞移植（aHCT）后患者的肾脏疾病发生率很高。虽然很少表演，肾活检可能有助于做出精确的诊断，因为可能涉及多种机制和危险因素，并相应地调整治疗。本病例系列旨在报告aHCT后肾损伤患者的活检结果。
■单中心回顾性病例系列。
■所有接受天然肾活检的个体，在2010年1月1日至2020年12月31日在蒙特利尔（加拿大）的三级医院接受aHCT的所有成年患者中，并从他们的医疗记录中提取临床数据。
■共纳入17例患者。活检的适应症包括急性肾损伤（n=6），慢性肾脏病（n=5），肾病综合征（n=4），和亚肾病性蛋白尿（n=2）。肾活检的病理结果是异质性的：10例患者显示血栓性微血管病（TMA）的证据，5的急性肾小管损伤，和4膜性肾病。急性间质性肾炎的病例，BK病毒肾病,免疫复合物肾病，局灶性和节段性肾小球硬化，微小变化疾病，和核型间质性肾炎也被描述。
■对aHCT后肾损伤的所有患者均未进行系统性肾活检。只有一小部分肾损害患者接受活检，使结果变得不那么普遍。
■肾活检可用于aHCT后的肾病患者，以做出准确的诊断并相应地调整治疗方案。该系列是少数已发表的研究之一，描述了在急性肾损伤和慢性肾脏疾病的情况下，aHCT后进行的活检的病理发现。TMA广泛存在于活检中，即使没有临床怀疑这种诊断，提示目前诊断TMA的临床标准对肾限制型TMA不够敏感.
■单中心回顾性病例系列。
■所有接受天然肾活检的个体，在2010年1月1日至2020年12月31日在蒙特利尔（加拿大）的三级医院接受aHCT的所有成年患者中，并从他们的医疗记录中提取临床数据。
■共纳入17例患者。活检的适应症包括急性肾损伤（n=6），慢性肾脏病（n=5），肾病综合征（n=4），和亚肾病性蛋白尿（n=2）。肾活检的病理结果是异质性的：10例患者显示血栓性微血管病（TMA）的证据，5的急性肾小管损伤，和4膜性肾病。急性间质性肾炎的病例，BK病毒肾病,免疫复合物肾病，局灶性和节段性肾小球硬化，微小变化疾病，和核型间质性肾炎也被描述。
■对aHCT后肾损伤的所有患者均未进行系统性肾活检。只有一小部分肾损害患者接受活检，使结果变得不那么普遍。
■肾活检可用于aHCT后的肾病患者，以做出准确的诊断并相应地调整治疗方案。该系列是少数已发表的研究之一，描述了在急性肾损伤和慢性肾脏疾病的情况下，aHCT后进行的活检的病理发现。TMA广泛存在于活检中，即使没有临床怀疑这种诊断，提示目前诊断TMA的临床标准对肾限制型TMA不够敏感.
