Acute Renal Failure in the Setting of Marrow Transplantation

Abstract

Acute renal failure (ARF) is a common complication of bone marrow transplantation (BMT) that confers a high mortality rate. There are multiple factors that contribute to ARF in the setting of BMT, and they can be conveniently divided based on time of occurrence. We review the most common causes of ARF in the setting of BMT and address prophylaxis and treatment issues. Acute renal failure seen within the first 5 days posttransplant can result from tumor lysis syndrome and marrow infusion toxicity. Within the first month posttransplant, ARF secondary to hepatic veno-occlusive disease is a common complication. Late renal failure, caused by radiation-induced hemolytic-uremic syndrome and cyclosporine toxicity, will also be reviewed. In addition, we discuss chronic renal insufficiency resulting from BMT.