title: Early-onset acute kidney injury is a poor prognostic sign for allogeneic SCT recipients.
abstract: Acute kidney injury (AKI) following stem-cell transplantation (SCT) contributes to a poor prognosis, yet its impact may vary depending on the timing of AKI onset. A prospective cohort study was performed to understand the significance of the onset timing in 103 allogeneic SCT (allo-SCT) recipients. AKI prior to stem-cell engraftment was defined as early AKI and subsequently occurring AKI as late AKI. Propensity score (PS) for early AKI was calculated using a logistic regression model to reduce confounding effects related to differences in clinical background between the early and late AKI groups. The cumulative incidences of early and late AKI were 22.3% and 54.9%, respectively. Non-relapse mortality (NRM) was 39.1% and 7.0%, and overall survival (OS) was 56.5% and 90.9% in early and late AKI at 100 days after AKI, respectively (P<0.001). The cumulative incidence of chronic kidney disease (CKD) over 2 years after SCT was 41.5% and 19.1% in early and late AKI, respectively (P=0.048). Logistic regression analysis adjusted for the PS showed that early AKI was significantly associated with OS (odds ratio (95% confidence interval); 4.63 (1.15-21.4), P=0.031) but with neither NRM (1.25 (0.28-5.33), P=0.766) nor CKD (1.85 (0.41-8.60), P=0.422). In conclusion, early AKI may portend a poor survival for allo-SCT recipients.
authors: Division of Hematology, Department of Medicine, Tokyo Metropolitan Cancer Center, Komagome Hospital, Tokyo, Japan.
authors: N
authors: N
authors: Shingai
authors: Division of Nephrology, Department of Medicine, Tokyo Metropolitan Cancer Center, Komagome Hospital, Tokyo, Japan.
authors: T
authors: T
authors: Morito
authors: Division of Hematology, Department of Medicine, Tokyo Metropolitan Cancer Center, Komagome Hospital, Tokyo, Japan.
authors: Y
authors: Y
authors: Najima
authors: Division of Hematology, Department of Medicine, Tokyo Metropolitan Cancer Center, Komagome Hospital, Tokyo, Japan.
authors: T
authors: T
authors: Kobayashi
authors: Division of Hematology, Department of Medicine, Tokyo Metropolitan Cancer Center, Komagome Hospital, Tokyo, Japan.
authors: N
authors: N
authors: Doki
authors: Division of Hematology, Department of Medicine, Tokyo Metropolitan Cancer Center, Komagome Hospital, Tokyo, Japan.
authors: K
authors: K
authors: Kakihana
authors: Division of Hematology, Department of Medicine, Tokyo Metropolitan Cancer Center, Komagome Hospital, Tokyo, Japan.
authors: K
authors: K
authors: Ohashi
authors: Division of Nephrology, Department of Medicine, Tokyo Metropolitan Cancer Center, Komagome Hospital, Tokyo, Japan.
authors: M
authors: M
authors: Ando
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality*; D000328:Adult; D000368:Aged; D064591:Allografts; D018572:Disease-Free Survival; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate