{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T21:31:29Z","timestamp":1776720689752,"version":"3.51.2"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,6,28]],"date-time":"2013-06-28T00:00:00Z","timestamp":1372377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Allogenic hematopoietic stem cell transplant (allo\u2010HSCT) is the treatment of choice for several hematological diseases. Although rare, patients could present nephrotic syndrome as a clinical feature of chronic graft\u2010versus\u2010host disease (<jats:styled-content style=\"fixed-case\">cGVHD<\/jats:styled-content>). The objective of our study is to screen patients with allo\u2010HSCT to determine who developed a glomerular pathology in the context of <jats:styled-content style=\"fixed-case\">cGVHD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>We studied patients who underwent allo\u2010HSCT treatment in our center between October 1995 and October 2012 and who developed glomerular pathology. <jats:styled-content style=\"fixed-case\">cGVHD<\/jats:styled-content> was defined as a pathology when it appeared after 100\u00a0d post\u2010allo\u2010HSCT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five hundred eighty\u2010three allo\u2010HSCT were performed. The prevalence of <jats:styled-content style=\"fixed-case\">cGVHD<\/jats:styled-content> of the kidney was 1.03%. All patients with <jats:styled-content style=\"fixed-case\">cGVHD<\/jats:styled-content> of the kidney were hosts who received peripheral blood from an identical HLA match donor. GVHD prophylaxis with calcineurin inhibitors plus methotrexate was administered in five cases, and prophylaxis with sirolimus was used in another case. <jats:styled-content style=\"fixed-case\">cGVHD<\/jats:styled-content> of the kidney was seen to appear after the removal of the prophylaxis for GVHD, within 33\u00a0\u00b1\u00a011.54\u00a0months intervals after allo\u2010HSCT in five patients and in another patient, it appeared despite immunosuppressive therapy being administered. All patients had proteinuria, within 11.82\u00a0\u00b1\u00a09.03\u00a0g\/d ranges. The kidney biopsies revealed membranous glomerulonephritis (four patients), focal segmental glomerulonephritis (one patient) and lupus nephropathy class III (one patient). It seems, immunosuppressive therapy achieved complete remission, within the first year of treatment in four patients. Although in three of them, the proteinuria recurred when we tried to remove the therapy; two patients have recently started treatment, being in partial remission now.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">cGVHD<\/jats:styled-content> of the kidney is a rare complication after allo\u2010HSCT, related with the removal of the immunosuppression. Monitoring proteinuria in these patients may be useful. In our patients, a complete remission was achieved; although the removal of the immunosuppression may lead to the appearance of outbreaks. We must reconsider the treatment of glomerular pathology secondary to <jats:styled-content style=\"fixed-case\">cGVHD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12149","type":"journal-article","created":{"date-parts":[[2013,5,24]],"date-time":"2013-05-24T16:48:45Z","timestamp":1369414125000},"page":"129-134","source":"Crossref","is-referenced-by-count":41,"title":["Chronic graft\u2010versus\u2010host disease of the kidney in patients with allogenic hematopoietic stem cell transplant"],"prefix":"10.1111","volume":"91","author":[{"given":"Fraile","family":"Pilar","sequence":"first","affiliation":[{"name":"Service of Nephrology University Hospital of Salamanca Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vazquez","family":"Lourdes","sequence":"additional","affiliation":[{"name":"Service of Hematology University Hospital of Salamanca Salamanca 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Matias","sequence":"additional","affiliation":[{"name":"Service of Nephrology University Hospital of Salamanca Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199907013410103"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01700407"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcma.2011.08.008"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2008.07.015"},{"key":"e_1_2_6_6_1","first-page":"247","article-title":"Consensus among bone marrow transplanters for diagnosis, grading and treatment of chronic graft\u2010versus\u2010host disease","volume":"4","author":"Atkinson K","year":"1989","journal-title":"Bone Marrow 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