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Acute kidney injury and risk factors in pediatric patients undergoing hematopoietic stem cell transplantation.
- Source :
-
Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Jul; Vol. 39 (7), pp. 2199-2207. Date of Electronic Publication: 2024 Feb 07. - Publication Year :
- 2024
-
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.<br />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.<br />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%).<br />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.<br /> (© 2024. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
- Subjects :
- Humans
Male
Female
Child
Risk Factors
Retrospective Studies
Case-Control Studies
Child, Preschool
Adolescent
Incidence
Prognosis
Renal Replacement Therapy statistics & numerical data
Renal Replacement Therapy adverse effects
Infant
Hematopoietic Stem Cell Transplantation adverse effects
Acute Kidney Injury epidemiology
Acute Kidney Injury etiology
Acute Kidney Injury therapy
Acute Kidney Injury mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1432-198X
- Volume :
- 39
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Pediatric nephrology (Berlin, Germany)
- Publication Type :
- Academic Journal
- Accession number :
- 38324191
- Full Text :
- https://doi.org/10.1007/s00467-024-06290-z