Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.1.1.69 (BMT)
 2,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In clinical practice p-creatinine is used to estimate changes of GFR. Generally, it is believed that recovery of p-creatinine within 10% of initial baseline allows exclusion of relevant nephrotoxic changes. We evaluated whether recovery of GFR after discontinuation of CyA therapy can be adequately predicted by measuring p-creatinine alone. Fifty-four allogenic BMT patients were followed up by p-creatinine and classical inulin clearance (GFR) before BMT and 1, 3, 6, 12, 18, 24 months after BMT. A total of 10 patients fulfilled following three criteria: (1) 24 months total follow-up time; (2) at least 12 months follow-up after discontinuation of CyA therapy (3) no trimethoprim or cimetidine comedication at time of clearance measurement. Time after CyA withdrawal varied between 13 and 21 months (mean +/- standard deviation, 17 +/- 2 months); mean duration of CyA therapy was 8 +/- 2 months (minimum: 3 months, maximum: 11 months). After at least 12 months of CyA stop mean p-creatinine returned to baseline values. In contrast, mean GFR remained about 20% below baseline (paired sample Wilcoxon-test P < .02). Neither creatinine excretion nor body weight nor creatinine clearance changed significantly between baseline and 24 months after BMT. Follow-up of p-creatinine after CyA stop can overestimate the recovery of GFR. A 20% loss of GFR may remain unrecognized. We speculate that this phenomenon is due to tubular hypertrophy in the recovery phase.
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PMID:Plasma creatinine for the evaluation of recovery of glomerular filtration rate after discontinuation of cyclosporine A in bone marrow transplantation: results of a prospective study. 794 Aug 4

Recent development of hematopoietic cell transplantation (HCT) has greatly improved the quality of life in critical patients with hematological malignancies. On the other hand, it is a fact that some HCT survivors suffer from chronic renal failure (CRF). We attempted to examine the clinical characteristics of CRF in patients who were successfully treated with HCT in Japan. A retrospective analysis of 158 long-term survivors receiving HCT at Komagome Hospital was undertaken. CRF was designated as less than 30 mL/min of estimated GFR (eGFR) calculated by the MDRD formula. We statistically analyzed the influences of total body irradiation (TBI), graft versus host diseases (GVHD), renal impairment during HCT, new incidence of hypertension after transplantation, age, and gender on CRF, using the multivariate logistic regression analysis. Twenty-seven patients (17.1%) had CRF. Their mean ages were 33.1 +/- 8.87 years and mean eGFR levels were 20.5 +/- 9.50 mL/min/1.73 m2. Fifteen patients were recipients of TBI (55.6 %). CRF became obvious within one year after BMT in 5 patients (18.5%) and later in 22 patients (81.5%). Seven patients(25.9%) finally reached end-stage renal disease (ESRD) at the time of over 10 years after HCT. Multivariate logistic regression analysis showed that TBI, renal impairment during HCT, and new incidence of hypertension after HCT were significantly associated with CRF. Considering that 12 patients without TBI (44.4%) developed CRF, "renal impairment during HCT", the odds ratio of which was the highest, might be the factor most closely associated with CRF. The clinical course of a representative patient who developed ESRD was described. An increase in ESRD patients receiving HCT should be anticipated and would constitute a new important issue in nephrology.
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PMID:[Chronic renal failure in patients successfully treated with hematopoietic cell transplantation]. 1842 68