Prospective evaluation of acute and chronic renal function in children following matched related donor hematopoietic stem cell transplantation.
Acute and chronic renal impairment are important complications after HSCT. A prospective study was conducted to investigate the glomerular renal function in children who received allogeneic HSCT from matched related donors. Non-radiation conditioning regimens were used in all but one patient. CrCl and serial measurements of serum creatinine were evaluated prior to HSCT, within the first 100 days and one yr after. AKI was defined as at least a 1.5-fold rise in pre-HSCT serum creatinine within the first 100 days and classified as grade 1 to 3 according to the new definition criteria proposed by "AKI Network." Fifty-seven patients were enrolled in the study and 24 patients (42%) had AKI. CsA, amphotericin B, and SOS were found as risk factors for AKI. One yr after HSCT five patients (10%) had CKD and none of them required dialysis. None of the parameters were found as a predictor for CKD. We conclude that AKI is an important complication of HSCT. Careful monitoring of renal function, minimizing the use of nephrotoxic medication, prophylaxis, and effective treatment of SOS might be effective preventive measures to decrease the incidence of AKI.
Ileri
Talia
T
Department of Pediatric Hematology, Ankara University School of Medicine, Ankara, Turkey. taliaileri@yahoo.com
Ertem
Mehmet
M
Ozcakar
Zeynep Birsin
ZB
Ince
Elif Unal
EU
Biyikli
Zeynep
Z
Uysal
Zumrut
Z
Ekim
Mesiha
M
Yalcinkaya
Fatos
F
D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous; D014463:Ultrasonography
D003404:Creatinine