Acute renal failure after myeloablative allogeneic hematopoietic stem cell transplantation: incidence, risk factors, and relationship with the quantity of transplanted cells.
OBJECTIVE
Acute renal failure (ARF) after hematopoietic stem cell transplantation (HSCT) is a widespread complication leading to considerable morbidity and mortality. The present study aims to determine the incidence and risk factors of ARF and to investigate whether there exists a relationship between the renal injury indicators and quantity of the transplanted stem cells in a uniform patient population after allogeneic myeloablative HSCT.


METHODS
Patients undergoing myeloablative allogeneic HSCT from 2007 to 2008 were monitored prospectively in terms of their renal functions during the first 100 days after transplantation. ARF was defined as a twofold rise in serum creatinine concentration of baseline value or a >50% decrease in creatinine clearance and classified into three grades.


RESULTS
ARF occurred in 51.3% of patients over a period of 100 days after HSCT. ARF developed in 12 (60.0%) patients within the first 2 weeks, whereas in 8 (40.0%) of them ARF development was observed within 2-4 weeks. No correlation was found between ARF development and the quantity of the infused hematopoietic stem cells. Additionally, we were not able to identify a particular cause which was significantly associated with the occurrence of ARF after HSCT.


CONCLUSIONS
A 51.3% incidence of ARF was found in patients after myeloablative allogeneic HSCT. ARF in HSCT patients could not be linked to a single cause. Rather a combination of multiple risk factors seems to be responsible for ARF development.
Tokgoz
Bulent
B
Department of Nephrology, Erciyes University School of Medicine, Kayseri 38039, Turkey. bulentto@gmail.com
Kocyigit
Ismail
I
Polat
Gülsah
G
Eser
Bulent
B
Unal
Aydin
A
Kaynar
Leylagul
L
Sipahioglu
Murat Hayri
MH
Oymak
Oktay
O
Utas
Cengiz
C
Cetin
Mustafa
M
D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000009:adverse effects; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult