Bone marrow transplant nephropathy successfully treated with angiotensin-converting enzyme inhibitor.
Bone marrow transplant nephropathy successfully treated with angiotensin-converting enzyme inhibitor.
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DOI：
10.1007/s10157-005-0394-3
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发表时间：
2006-03-01
影响因子：
2.3
通讯作者：
Yuzawa, Yukio
中科院分区：
文献类型：
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作者：
Ichida, Shizunori;Okada, Keiko;Yuzawa, Yukio
我们报告一位因PH1(+)急性淋巴细胞白血病接受异基因造血干细胞移植(HSCT)治疗11个月后发生慢性肾功能衰竭的患者。肾活检显示典型的病理结果符合骨髓移植肾病(骨髓移植肾病)。骨髓移植肾病的一般病程是缓慢进展的，最终达到终末期肾功能衰竭。血管紧张素转换酶抑制剂(ACE-I)替莫普利开始对该患者进行干预治疗，这是基于几份显示ACE-IS对骨髓移植肾病的保护作用的实验报告。该患者在应用血管紧张素转换酶I后，肾功能消退率明显降低，血肌酐维持在几乎相同的水平长达18个月。虽然这位患者的观察过程很短，但我们清楚地表明了ACE-I在防止人类骨髓移植肾病进展为终末期肾功能衰竭方面的效果，而不是在实验模型中。
We report a patient who developed chronic renal failure 11 months after an allogeneic hematopoietic stem-cell transplantation (HSCT) for Ph1(+) acute lymphocytic leukemia. Renal biopsy showed typical pathological findings compatible with a bone marrow transplant nephropathy (BMT nephropathy). The general course of BMT nephropathy is slowly progressive, eventually reaching endstage renal failure. Intervention therapy with an angiotensin-converting enzyme inhibitor (ACE-I), temocapril, was started for this patient, based on several experimental reports showing the protective effects of ACE-Is on BMT nephropathy. After the induction of ACE-I in this patient, the rate of regression of renal function was significantly reduced and his serum creatinine was maintained at almost the same level for 18 months. Although the course of observation in this patient was short, we clearly showed the effects of an ACE-I on preventing BMT nephropathy from progressing to endstage renal failure in a human rather than in an experimental model.