PMID: 22351993Feb 23, 2012Paper

Early identification of acute kidney injury after hematopoietic stem cell transplantation by the measurement of urinary biomarkers

Nihon Jinzo Gakkai shi
T MoritoK Nitta

Abstract

Myeloablative (m-allo) hematopoietic stem cell transplantation (SCT) involves a great risk of acute kidney injury (AKI). We assessed whether or not early elevation of urinary biomarkers is useful for identifying high-risk patients for AKI. A prospective cohort study was conducted in 40 patients (46.0+/-12.5 years, eGFR 96.1 +/- 25.3 mL/min/1.73 m2) who received m-allo SCT in our hospital. We measured urinary biomarkers such as N-acetyl-beta -glucosaminidase (NAG), beta2 microglobulin (beta 2M), alpha microglobulin ( alpha1M) before conditioning therapy, on the day of SCT and both days 7 and 14 after SCT. AKI was defined as a decrease in eGFR within 100 days after SCT, and classified based on the RIFLE criteria. Discriminative sensitivity of urinary biomarkers was estimated using area under receiver operating characteristic (AuROC) curve analysis. AKI occurred in 28 cases(70 %): risk was 25.0 %, injury was 17.5 %, failure was 22.5 % and loss was 5.0 %, respectively. Only 4 cases with AKI > or = injury that occurred less than 40 days after SCT died within 100 days after SCT. Thus, this level of AKI was denoted as"severe AKI"and targeted for early identification. Values of all urinary biomarkers increased gradually after the condi...Continue Reading

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