Kidney failure in the course of focal segmental glomerulonephritis in a patient after alloHSCT - a case study and review of the literature.

Nephrotic syndrome is a rare complication of allogeneic haematopoietic stem cell transplantation (alloHSCT). Its pathogenesis is not fully understood. Membranous nephropathy and minimal change disease are the most common causes of nephrotic syndrome. Nephrotic syndrome occurs more frequently in people with chronic graft-versus-host disease (GvHD). Glucocorticosteroids and cyclosporine are the most common treatments, but their use is associated with the risk of side effects and variable responses. We present a case of a patient after alloHSCT with advanced GvHD who developed nephrotic syndrome resistant to immunosuppressive treatment. Additionally, when her kidney function deteriorated, she required kidney replacement therapy. We would like to emphasise the importance of kidney biopsy as a tool for determining the extent of kidney damage and the possible response to therapy.