Risk factors for acute kidney injury after hematopoietic stem cell transplantation in children: a retrospective study

LIU Jian; CHEN Zhi-Wei; WANG Ying-Jie; MAI Yu-Miao; HU Hui-Hui; REN Bing; WANG Ying-Chao; LIU Yu-Feng

doi:10.7499/j.issn.1008-8830.2205007

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Chinese Journal of Contemporary Pediatrics ›› 2022, Vol. 24 ›› Issue (10) : 1136-1142. DOI: 10.7499/j.issn.1008-8830.2205007

CLINICAL RESEARCH

Risk factors for acute kidney injury after hematopoietic stem cell transplantation in children: a retrospective study

LIU Jian, CHEN Zhi-Wei, WANG Ying-Jie, MAI Yu-Miao, HU Hui-Hui, REN Bing, WANG Ying-Chao, LIU Yu-Feng

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Abstract

Objective To investigate the risk factors for acute kidney injury (AKI) after hematopoietic stem cell transplantation (HSCT) in children. Methods A retrospective analysis was performed on the medical data of 111 children who underwent HSCT from January 2018 to January 2020. A multivariate logistic regression analysis was used to identify the risk factors for AKI. The Kaplan-Meier survival analysis was used to compare the prognosis in children with different grades of AKI. Results Graft-versus-host disease (grade Ⅱ-Ⅳ) (OR=4.406, 95%CI: 1.501-12.933, P=0.007), hepatic veno-occlusive disease (OR=4.190, 95%CI: 1.191-14.740, P=0.026), and thrombotic microangiopathy (OR=10.441, 95%CI: 1.148-94.995, P=0.037) were closely associated with the development of AKI after HSCT. The children with stage Ⅲ AKI had a lower 1-year survival rate than those without AKI or with stage Ⅰ AKI or stage Ⅱ AKI (28.6%±12.1% vs 82.8%±5.2%/81.7%±7.4%/68.8%±11.6%; P<0.05). Conclusions Children with stage Ⅲ AKI after HSCT have a higher mortality rate. Graft-versus-host disease, hepatic veno-occlusive disease, and thrombotic microangiopathy are closely associated with the development of AKI after HSCT.

Key words

Hematopoietic stem cell transplantation / Acute kidney injury / Risk factor / Child

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LIU Jian, CHEN Zhi-Wei, WANG Ying-Jie, MAI Yu-Miao, HU Hui-Hui, REN Bing, WANG Ying-Chao, LIU Yu-Feng. Risk factors for acute kidney injury after hematopoietic stem cell transplantation in children: a retrospective study[J]. Chinese Journal of Contemporary Pediatrics. 2022, 24(10): 1136-1142 https://doi.org/10.7499/j.issn.1008-8830.2205007

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