Pretransplant predictors and posttransplant sequels of acute kidney injury after allogeneic stem cell transplantation

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Yuki KagoyaMineo Kurokawa

Abstract

Acute kidney injury (AKI) is a common complication after allogeneic stem cell transplantation (SCT). Although various risk factors for AKI have been reported, the influence of pretransplant comorbidity on the incidence of AKI has not been well investigated. We performed a retrospective analysis of 207 consecutive patients undergoing myeloablative or nonmyeloablative SCT between 2001 and 2009, using the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) as a representative of pretransplant comorbidities. According to Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, 158 patients (76.3%) developed AKI, and 92 patients (44.4%) developed severe AKI (RIFLE class I or class F) within 100 days after SCT. The cumulative incidence of severe AKI within 100 days in patients with an HCT-CI score 0, 1-2, and ≥3 was 21.3%, 48.8%, and 73.9%, respectively. In multivariate analysis, the HCT-CI was independently associated with severe AKI (HCT-CI 1-2: adjusted hazard ratio [HR] 2.42, P < .01; HCT-CI ≥3: adjusted HR 4.69, P < .01). In a landmark analysis, patients with severe AKI had a lower 3-year overall survival (OS) (39.3% versus 61.4%, P < .01), and a higher 3-year nonrelapse mortality (NRM) (40....Continue Reading

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Citations

Feb 9, 2016·Bone Marrow Transplantation·J A LopesM Neves
Sep 7, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Naoki ShingaiMinoru Ando
Jan 3, 2013·Transplant Infectious Disease : an Official Journal of the Transplantation Society·H MaeA Tojo
Oct 12, 2014·Revista brasileira de hematologia e hemoterapia·Juliana Bastoni da SilvaSílvia Regina Secoli
Jun 9, 2016·The New England Journal of Medicine·Sangeeta Hingorani
Dec 7, 2013·Clinical Journal of the American Society of Nephrology : CJASN·Tomoko FujiiRinaldo Bellomo
Nov 26, 2016·International Journal of Nephrology·Vinod KrishnappaRupesh Raina
Jan 9, 2020·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Victoria GutgartsJuliet N Barker
Sep 30, 2019·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Matt S ZinterChristopher C Dvorak
Sep 10, 2021·Clinical and Experimental Nephrology·Shuiying LiuFeng Wang

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