title: [Renal insufficiency after allogeneic stem cell transplantation in children].
abstract: 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.
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto.
authors.forename: Itaru
authors.initials: I
authors.lastname: Kato
authors.forename: Katsutsugu
authors.initials: K
authors.lastname: Umeda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsubara
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Hiramatsu
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Souichi
authors.initials: S
authors.lastname: Adachi
authors.forename: Tatsutoshi
authors.initials: T
authors.lastname: Nakahata
mesh_terms: 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
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D003404:Creatinine