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Acute kidney injury and risk factors in pediatric patients undergoing hematopoietic stem cell transplantation.
Avci, Begüm; Bilir, Özlem Arman; Özlü, Sare Gülfem; Kanbur, Serife Mehtap; Gökçebay, Dilek Gürlek; Bozkaya, Ikbal Ok; Bayrakçi, Umut Selda; Özbek, Namik Yasar.
Afiliação
  • Avci B; Department of Pediatric Nephrology, Baskent University, Adana Dr. Turgut Noyan Application and Research Center, Adana, Turkey. begumavcidr@gmail.com.
  • Bilir ÖA; Department of Pediatric Nephrology, Ankara Bilkent City Hospital, Health Sciences University, Ankara, Turkey. begumavcidr@gmail.com.
  • Özlü SG; Department of Pediatric Hematology/Oncology and Pediatric Bone Marrow Transplantation Unit, Ankara Bilkent City Hospital, Health Sciences University, Ankara, Turkey.
  • Kanbur SM; Department of Pediatric Nephrology, Ankara Bilkent City Hospital, Yildirim Beyazit University, Ankara, Turkey.
  • Gökçebay DG; Department of Pediatric Hematology/Oncology and Pediatric Bone Marrow Transplantation Unit, Ankara Bilkent City Hospital, Health Sciences University, Ankara, Turkey.
  • Bozkaya IO; Department of Pediatric Hematology/Oncology and Pediatric Bone Marrow Transplantation Unit, Ankara Bilkent City Hospital, Health Sciences University, Ankara, Turkey.
  • Bayrakçi US; Department of Pediatric Hematology/Oncology and Pediatric Bone Marrow Transplantation Unit, Ankara Bilkent City Hospital, Health Sciences University, Ankara, Turkey.
  • Özbek NY; Department of Pediatric Nephrology, Ankara Bilkent City Hospital, Yildirim Beyazit University, Ankara, Turkey.
Pediatr Nephrol ; 39(7): 2199-2207, 2024 Jul.
Article em En | MEDLINE | ID: mdl-38324191
ABSTRACT

BACKGROUND:

Acute kidney injury (AKI) is a common complication of hematopoietic stem cell transplantation (HSCT) with increased mortality and morbidity. Understanding the risk factors for AKI is essential. This study aimed to identify AKI incidence, risk factors, and prognosis in pediatric patients post-HSCT.

METHODS:

We conducted a retrospective case-control study of 278 patients who were divided into two groups those with AKI and those without AKI (non-AKI). The groups were compared based on the characteristics and clinical symptoms of patients, as well as post-HSCT complications and the use of nephrotoxic drugs. Logistic regression analysis was employed to identify the risk factors for AKI.

RESULTS:

A total of 16.9% of patients had AKI, with 8.5% requiring kidney replacement therapy. Older age (OR 1.129, 95% CI 1.061-1.200, p < 0.001), sinusoidal obstruction syndrome (OR 2.562, 95% CI 1.216-5.398, p = 0.011), hemorrhagic cystitis (OR 2.703, 95% CI 1.178-6.199, p = 0.016), and nephrotoxic drugs, including calcineurin inhibitors, amikacin, and vancomycin (OR 17.250, 95% CI 2.329-127.742, p < 0.001), were identified as significant independent risk factors for AKI following HSCT. Mortality rate and mortality due to AKI were higher in stage 3 patients than those in stage 1 and 2 AKI (p = 0.019, p = 0.007, respectively). Chronic kidney disease developed in 1 patient (0.4%), who was in stage 1 AKI (2.1%).

CONCLUSIONS:

AKI poses a serious threat to children post-HSCT, leading to alarming rates of mortality and morbidity. To enhance outcomes and mitigate these risks, it is vital to identify AKI risk factors, adopt early preventive strategies, and closely monitor this patient group.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Células-Tronco Hematopoéticas / Injúria Renal Aguda Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Células-Tronco Hematopoéticas / Injúria Renal Aguda Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Ano de publicação: 2024 Tipo de documento: Article