CASE REPORT

Clinical and Experimental Nephrology

, Volume 10, Issue 1, pp 78-81

Bone marrow transplant nephropathy successfully treated with angiotensin-converting enzyme inhibitor

  • Shizunori IchidaAffiliated withDivision of Nephrology, Japanese Red Cross Nagoya First Hospital Email author 
  • , Keiko OkadaAffiliated withDivision of Nephrology, Japanese Red Cross Nagoya First Hospital
  • , Michie ItohAffiliated withDivision of Nephrology, Japanese Red Cross Nagoya First Hospital
  • , Rieko OkadaAffiliated withDivision of Nephrology, Japanese Red Cross Nagoya First Hospital
  • , Noritoshi KatohAffiliated withDivision of Nephrology, Japanese Red Cross Nagoya First Hospital
  • , Masanobu KasaiAffiliated withDivision of Hematology, Japanese Red Cross Nagoya First Hospital
  • , Yukio YuzawaAffiliated withDivision of Clinical Immunology, Department of Medicine, Nagoya University Graduate School of Medicine

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Abstract

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.

Key words

Angiotensin-converting enzyme inhibitor BMT nephropathy Chronic renal failure Hematopoietic stem-cell transplantation Radiation nephritis