[Renal insufficiency after allogeneic stem cell transplantation in children].
We retrospectively evaluated the incidence of renal insufficiency (RI) and risk factors involved in RI in 27 pediatric cases that underwent their first hematopoietic stem cell transplantation (HSCT) in our hospital. Median patient age was 7 years (7 months-16 years); 19 cases demonstrated hematological malignant disease and 8 cases showed non-malignant disease, respectively. Nineteen cases were transplanted from unrelated donors. The incidence of acute and chronic RI was 51.9% and 22.2%, respectively. The intensity of the conditioning regimen, the dose of TBI, GVHD prophylaxis, and the grade of GVHD did not significantly affect the incidence of either acute or chronic RI. Patients over 13 years old were at high risk for chronic RI. Furthermore, the incidence of chronic RI was significantly higher in patients showing a serum creatinine increase during the acute phase of HSCT that was more than three times the pre-HSCT level. RI prophylaxis such as ACE inhibitors or AII receptor antagonists is needed for older children and for those demonstrating severe RI at the early stage after HSCT.
Kato
Itaru
I
Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto.
Umeda
Katsutsugu
K
Matsubara
Hiroshi
H
Hiramatsu
Hidefumi
H
Watanabe
Ken-Ichiro
K
Adachi
Souichi
S
Nakahata
Tatsutoshi
T
D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D000293:Adolescent; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D010372:Pediatrics; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D003404:Creatinine