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Acute Kidney Injury in Young Allo-HCT Recipients

Biol Blood Marrow Transplant; ePub 2017 Nov 28; Koh, et al

Acute kidney injury (AKI) is prevalent following pediatric allogeneic hematopoietic cell transplantation (HCT), researchers concluded after conducting a retrospective analysis involving >1,000 individuals. Investigators looked at AKI incidence and risk during the first 100 days post-HCT, as well as its impact on survival, in pediatric patients who received allogeneic HCT. Among the results:

  • Cumulative incidence of all stages of AKI was 68%.
  • Stage 3 AKI and AKI requiring renal replacement therapy (RRT) incidences were 25% and 8%, respectively.
  • 1-year overall survival rates were similar in patients without AKI and those with stage 1 or 2 disease.
  • Overall survival rates were significantly different in patients without AKI and those with stage 3 disease with or without RRT (66% vs 47%).
  • Independent risk factors for stage 1 through 3 AKI included age, year of transplantation, donor type, sinusoidal obstruction syndrome (SOS), and acute graft-versus-host disease (GVHD).
  • Independent risk factors for AKI requiring RRT included age, donor, conditioning regimen, number of HCTs, SOS, and acute GVHD.

Citation:

Koh K, Sunkara A, Kang G, et al. Acute kidney injury in pediatric patients receiving allogeneic hematopoietic cell transplantation: Incidence, risk factors, and outcomes. [Published online ahead of print November 28, 2017]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2017.11.021.

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