Acute renal failure after allogeneic myeloablative stem cell transplantation: retrospective analysis of incidence, risk factors and survival

Kersting, Sabina; Koomans, Hein A.; Hené, Ronald J.; Verdonck, Leo F.

doi:10.1038/sj.bmt.1705599

Cited by 96 publications

(94 citation statements)

References 24 publications

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“…In this multicenter study, 12.9% of patients developed AKI grades 2-3. This is much less significant compared with those reported in myeloablative HSCT (49.6%) and nonmyeloablative HSCT (32.7%) by Kersting et al 6,7 The incidence is also less than that reported by Parikh et al 9 (myeloablative HSCT ¼ 73%; nonmyeloablative HSCT ¼ 47%). Controlling for clinical variables, Parikh et al 9 found that the risk of developing renal failure was nearly fivefold less for nonmyeloablative transplantation compared with that for myeloablative regimens.…”

Section: Discussioncontrasting

confidence: 51%

“…If ARF is defined as a doubling of baseline serum creatinine (SCr) in the first 100 days after transplantation, the incidence of ARF varies from 42 to 84%, and ARF seems to independently influence mortality after myeloablative HSCT. [3][4][5][6] The incidence of ARF after nonmyeloablative HSCT is lower than that of myeloablative HSCT, and varies from 33-42%. Moreover, ARF is also an indicator of decreased survival.…”

Section: Introductionmentioning

confidence: 99%

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A multicenter, retrospective study of acute kidney injury in adult patients with nonmyeloablative hematopoietic SCT

et al. 2009

Bone Marrow Transplant

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Acute kidney injury (AKI) is a common early complication in patients with hematopoietic SCT (HSCT). However, there are limited data about the incidence and risk factors of AKI in patients with nonmyeloablative HSCT. We conducted a multicenter, retrospective cohort study of 62 patients from three institutions who were treated with similar protocols for nonmyeloablative HSCT. AKI was classified according to the Acute Kidney Injury Network criteria. It was shown that 29% of the patients developed AKI in the first 100 days after nonmyeloablative HSCT. The risk factor at baseline for AKI was incomplete HLA-matched transplant (odds ratio (OR) 3.6; 95% confidence interval (CI) 1.1-13.0). Complications such as acute GVHD, veno-occlusive disease of liver and sepsis were also associated with the development of AKI (OR 12.1; 95% CI 2.4-62.4). AKI was significantly associated with mortality (OR ¼ 4.7; 95% CI 1.9-11.5). We concluded that AKI is a very common complication in patients with nonmyeloablative HSCT, which is associated with incomplete HLAmatched transplant and complications, and has an important impact on the patients' first year of survival.

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Section: Discussioncontrasting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

A multicenter, retrospective study of acute kidney injury in adult patients with nonmyeloablative hematopoietic SCT

et al. 2009

Bone Marrow Transplant

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“…Acute tubular necrosis (ATN) 26,30,31 is also a common etiology of AKI in HCT patients and can ultimately overlap with prerenal azotemia due to volume depletion from dehydration (ischemic ATN) or sepsis (ischemic and/or nephrotoxic ATN). Patients can develop ischemic ATN in the context of hypovolemic or septic shock or nephrotoxic ATN as a result of drugs required for transplant, such as chemotherapy medication (cytarabine, carmustine, busulfan and fludarabine), antimicrobial agents (amphotericin B, aminoglycosides and vancomycin) and calcineurin inhibitors and methotrexate (MTX) used for GVHD prophylaxis and treatment.…”

Section: Pathogenesismentioning

confidence: 99%

“…Interestingly, when AKI is associated with hepatic SOS, the time for onset of AKI is significantly shorter, usually occurring within the first 2 weeks. 26 It is also worth mentioning that engraftment syndrome (ES) typically emerging in the first month following HCT may largely contribute to AKI within this time period. In a retrospective study comprising 377 patients with light-chain amyloidosis submitted to autologous HCT, the majority of AKI cases seemed to be linked to ES.…”

Section: Incidencementioning

confidence: 99%

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Acute kidney injury in HCT: an update

Lopes

Jorge

Neves

2016

Bone Marrow Transplant

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Acute kidney injury (AKI) is highly prevalent whether the patients undergo myeloablative or non-myeloablative hematopoietic cell transplantation (HCT); however, the pathogenesis and risk factors leading to AKI can differ between the two. The prognosis of AKI in patients receiving HCT is poor. In fact, AKI following HCT is associated not only with increased short-and long-term mortality, but also with progression to chronic kidney disease. Herein, the authors provide a comprehensive and up-to-date review of the definition and diagnosis, as well as of the incidence, pathogenesis and outcome of AKI in patients undergoing HCT, centering on the differences between myeloablative and non-myeloablative regimens. INTRODUCTIONHematopoietic cell transplantation (HCT) is currently used to treat numerous malignant (for example, multiple myeloma, leukemias and lymphomas) and non-malignant hematological disorders (for example, aplastic anemia, b-thalassemia, immunodeficiency disorders and inborn errors of metabolism), as well as solid tumors (for example, breast cancer and neuroblastoma), which are in other instances incurable.The two major HCT procedures, taking into consideration the conditioning regimen used, are myeloablative autologous and allogeneic HCT and non-myeloablative allogeneic HCT. On the one hand, myeloablative HCT utilizes the maximally tolerated dose of TBI with or without chemotherapy, or with chemotherapy alone. On the other hand, non-myeloablative HCT depends more on donor cellular immune effects and less on the cytotoxic effects of the preparative regimen to control the underlying disease. 1,2 It ultimately uses a lower dose conditioning regimen and can thus be offered to older patients, to those debilitated by additional comorbidities, or to high-risk, heavily pretreated patients, who would not tolerate myeloablative HCT, resulting in a consequent decrease in regimen-related toxicity and treatment-related mortality. [3][4][5] Acute kidney injury (AKI) is highly prevalent whether the patients undergo myeloablative or non-myeloablative regimens; however, the pathogenesis and risk factors leading to AKI can differ between the two. In fact, AKI in patients receiving HCT is associated not only with increased short-and long-term mortality as compared with patients with no AKI, but also with a higher rate of progression to chronic kidney disease (CKD). Herein, the authors provide a comprehensive and up-to-date review of the definition and diagnosis of AKI as well as of the incidence, risk factors, pathogenesis and outcome of AKI in patients undergoing HCT, centering on the differences between myeloablative and nonmyeloablative regimens.

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Kidney and Bladder Complications of Hematopoietic Cell Transplantation

Hingorani¹

2015

Thomas’ Hematopoietic Cell Transplantation

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Acute renal failure after allogeneic myeloablative stem cell transplantation: retrospective analysis of incidence, risk factors and survival

Cited by 96 publications

References 24 publications

A multicenter, retrospective study of acute kidney injury in adult patients with nonmyeloablative hematopoietic SCT

A multicenter, retrospective study of acute kidney injury in adult patients with nonmyeloablative hematopoietic SCT

Acute kidney injury in HCT: an update

Kidney and Bladder Complications of Hematopoietic Cell Transplantation

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