Complications rénales au décours de la greffe de cellules souches hématopoïétiques

Need for hemodialysis in patients undergoing hematopoietic stem cell transplantation: risk factors and survival in a retrospective cohort

“…In contrast, beyond D+30, age and other conditions can significantly contribute to AKI, such as microangiopathy, graft versus host disease (GVHD), drugs, cumulative nephrotoxic events and viral reactivations, such as BK (polyomavirus) and adenovirus. 4 , 5 …”

“… 1 , 5 On the other hand, studies have shown that some drugs (such as CNI) and successive AKI events in patients following allo-HSCT may induce cumulative kidney toxicity in the long-term, which could evolve to kidney function loss and, consequently, require renal replacement therapy (RRT). 1 , 2 , 3 , 4 , 5 , 6 Some studies have shown mortality rates of 55 to 100% in allo-HSCT patients requiring RRT. 1 , 5 …”

“…The reported incidences of AKI and dialysis in the allo-HSCT setting could range from 36% to 73% and 4% to 15%, respectively. 1 , 2 , 3 , 4 , 5 , 6 The AKI consequences can trigger positive feedback to patient deterioration caused by hypervolemia, decreased ability to fight infection and platelet dysfunction. 1 , 2 , 3 , 4 , 5 A new kidney injury classification, defined as KDIGO (Kidney Disease: Improving Global Outcomes), has been recently established and is considered more sensitive to detect AKI 7 than RIFLE.…”

“… 1 , 2 , 3 , 4 , 5 , 6 The AKI consequences can trigger positive feedback to patient deterioration caused by hypervolemia, decreased ability to fight infection and platelet dysfunction. 1 , 2 , 3 , 4 , 5 A new kidney injury classification, defined as KDIGO (Kidney Disease: Improving Global Outcomes), has been recently established and is considered more sensitive to detect AKI 7 than RIFLE. However, the KDIGO 7 criteria have not been routinely assessed in allo-HSCT patients yet.…”

“…The literature addressing hemodialysis in allo-HSCT is, therefore, heterogeneous, often reporting only short-term incidences, 1 , 2 , 4 , 5 and risk factors for this severe complication remain poorly understood. We designed a retrospective single-institution study in Brazil to investigate the one-year cumulative incidence and risk factors for hemodialysis in patients undergoing allo-HSCT.…”