Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Acute Kidney Injury in Patients Undergoing HCT

Biol Blood Marrow Transplant; ePub 2017 Dec 29; Clemmons, et al

Acute kidney injury (AKI) risk in patients undergoing hematopoietic cell transplantation (HCT) seems to vary depending on which antimicrobial medications are used, researchers concluded after conducting a single-center retrospective review involving 170 individuals. Participants underwent either autologous (n=110) or allogeneic (n=60) HCT. Investigators compared AKI incidence in patients who received vancomycin with either piperacillin/tazobactam concomitantly or cefepime alone prior to engraftment. Among the results:

  • Overall, 68% of patients who received piperacillin/tazobactam experienced AKI, vs 27% of those who were given cefepime.
  • Those receiving antimicrobials concomitantly were >5 time more likely to experience AKI after adjusting for hypotension.
  • Time to onset of AKI was more common within 48 hours of concomitant antimicrobial use (53% and 26%, respectively).
  • AKI incidence in autologous recipients in the 2 medication groups was 59% and 22%, respectively.
  • In the allogeneic sub-group, AKI incidence was 79% and 39%, respectively.
  • AKI resolution by discharge date was similar.


Clemmons A, Bech C, Pantin J, Ahmad I. Acute kidney injury in hematopoietic cell transplantation patients receiving vancomycin and piperacillin/tazobactam versus vancomycin and cefepime. [Published online ahead of print December 29, 2017]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2017.12.799.

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