Parameters:
(1) age of the patient at the time of HCT
(2) drug exposure for graft vs host disease (prophylaxis and/or treatment)
(3) primary diagnosis
|
Parameters
|
Findings
|
Points
|
|
age of the patient
|
<= 45 years
|
0
|
|
|
> 45 years
|
1
|
|
primary diagnosis
|
multiple myeloma
|
1
|
|
|
other
|
0
|
|
therapy with cyclosporine
|
no
|
0
|
|
|
yes
|
1
|
|
therapy with tacrolimus
|
no
|
0
|
|
|
yes
|
1
|
where:
• The relative risk for age at HCT was 1.3 per 5 year increment.
• Additional drugs may be used for graft vs host disease: prednisone, thalidomide, mycophenolate mofetil, and/or methotrexate.
total number of risk factors =
= SUM(points for the 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The risk of renal disease increases with the number of risk factors.
• The number of risk factors also increases with time after the HCT, with a plateau after 10 years.
Other factors to consider:
(1) pre-existing renal damage
(2) diabetes mellitus
(3) use of nephrotoxic drugs (aminoglcyosides, vancomycin, etc).
