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Nephrology Update: Winter 2014

Review the Winter 2014 issue of Nephrology Update, featuring program updates, research and treatments at The Children's Hospital of Philadelphia.

Transplant Immunosuppression
While current immunosuppressive regimens are very good at preventing rejection in the first year after transplantation, long-term outcomes remain relatively poor due to long-term graft injury. In addition, patients suffer significant toxicity and become vulnerable to loss of essential immunity protecting the recipient from infections and cancers.

Bone Fractures
Chronic kidney disease (CKD) poses multiple threats to bone accrual during growth. A recent study from The Children’s Hospital of Philadelphia, published in the Journal of Endocrinology and Metabolism, sought to clarify if children with CKD and low peripheral quantitative computed tomography (pQCT) measures of cortical volumetric bone mineral density (CortBMD) would be uniquely vulnerable to impaired mineralization and at a higher risk for fractures.

Kidney Disease Cancer Survivors
Acute kidney injury and chronic kidney disease are common complications in this patient population, especially among those who have received a hematopoietic stem cell transplant (HSCT). Alarmingly, children requiring dialysis for acute kidney injury after HSCT have mortality rates >70%. While the exact prevalence is unknown, estimates suggest that chronic kidney disease probably affects about 1 in 5 long-term survivors of childhood cancer.

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