1. Risk Factors for Acute Kidney Injury and Chronic Kidney Disease following Allogeneic Hematopoietic Stem Cell Transplantation for Hematopoietic Malignancies.
- Author
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Sakaguchi, Masahiro, Nakayama, Kazutaka, Yamaguchi, Hiroki, Mii, Akiko, Shimizu, Akira, Inai, Kazuki, Onai, Daishi, Marumo, Atsushi, Omori, Ikuko, Yamanaka, Satoshi, Fujiwara, Yusuke, Fukunaga, Keiko, Ryotokuji, Tsuyoshi, Hirakawa, Tsuneaki, Okabe, Masahiro, Tamai, Hayato, Okamoto, Muneo, Wakita, Satoshi, Yui, Shunsuke, and Tsuruoka, Shuichi
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CHRONIC kidney failure , *ACUTE kidney failure , *KIDNEY injuries , *HEMATOLOGIC malignancies , *GRAFT versus host disease , *HEMATOPOIETIC stem cell transplantation , *TOTAL body irradiation - Abstract
Background: Acute kidney injury (AKI) and chronic kidney disease (CKD) are considered common complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Objectives and Method: In this study, 114 patients who had undergone allo-HSCT were retrospectively analyzed to investigate the risk factors for onset of posttransplant AKI and CKD as defined by the new Kidney Disease Improving Global Outcomes criteria. Results: Seventy-four patients (64.9%) developed AKI and 25 (21.9%) developed CKD. The multivariate analysis showed that the risk factors for developing stage 1 or higher AKI were age ≥46 years at the time of transplant (p = 0.001) and use of ≥3 nephrotoxic drugs (p = 0.036). For CKD, the associated risk factors were disease status other than complete remission at the time of transplantation (p = 0.018) and onset of AKI after transplant (p = 0.035). The 5-year overall survival (OS) was significantly reduced by development of AKI (p < 0.001), but not CKD. Posttransplant AKI significantly increased the 5-year nonrelapse mortality (p < 0.001), whereas posttransplant CKD showed an increasing tendency, but the difference was not significant. Conclusions: Posttransplant AKI impacts OS, significantly increases the risk of CKD, and is significantly associated with disseminated intravascular coagulation and use of ˃3 nephrotoxic drugs. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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