Nephrolithiasis in pediatric hematopoietic cell transplantation with up to 40 years of follow-up

Abstract

Background Kidney stones have been reported to occur after childhood cancer, but little is known about kidney stones in children following hematopoietic cell transplantation (HCT). The objective of this retrospective study was to determine risk factors for the development of kidney stones and to describe the prevalence among survivors. Procedure The study included 1,343 childhood HCT patients. Mean follow‐up was 15.8 (1.0–40.0) years. Patients were treated with total body irradiation (TBI) (n = 948) or non‐TBI regimens. Methotrexate (MTX) for acute graft‐versus‐host disease (GVHD) prophylaxis was given as long‐course (n = 360), short‐course (n = 626), or none (n = 357). Prednisone for chronic GVHD therapy was received by 525 patients. Multivariate Cox regression models were used to estimate the hazard ratio (HR) of risk factors associated with kidney stones. Results Kidney stones developed in 51 patients, a median of 9.9 (0.2–29.4) years after first HCT, with a 30‐year cumulative incidence of 7.4%. Risk factors associated with kidney stones were TBI (HR = 2.2; P = 0.03), age at HCT (12–18 vs. <6 years, HR = 2.7; P = 0.01), MTX (long vs. none, HR = 3.6; P = 0.02), and prednisone (HR = 2.2; P = 0.008). Among 868 survivors, the prevalence of a history of kidney stones was 4.7%. Conclusions Survivors of childhood HCT have an increased risk of developing kidney stones. Pediatr Blood Cancer 2014;61:417–423. © 2013 Wiley Periodicals, Inc.

Long-term risk of renal and urinary tract diseases in childhood cancer survivors: A population-based cohort study

“…A study from St. Jude Children's Research Hospital comprising 2095 acute lymphoblastic leukaemia patients reported an incidence for urolithiasis of 1.8 per 10,000 person-years; however, this study was based on three cases only [38]. The relatively high number of survivors with urolithiasis in our study may be explained by increasingly more patients treated with haematopoietic stem cell transplantation and total body irradiation since the beginning of the 1980s [39].…”

Perfil Clínico-Epidemiológico De 106 Pacientes Pediátricos Portadores De Urolitíase No Rio De Janeiro

“…A few authors have explored the frequency of use of potentially lithogenic drugs in children. Hoffmeister et al 29 reported that 4.7% of the patients who used methotrexate presented with urolithiasis, whereas Mahmoud et al 30 referred that 5.2% of the patients who used topiramate also presented with urolithiasis. In the sample of this study, the frequency of use of these drugs was 4.7%.…”

Long-Term Side Effects of Hematopoietic Stem CeTransplantation in Children: A Single Center Experience.

“…In a study by Hoffmeister et al 23 , nephrolithiasis rate in HSCT patients was reported as 4.7%. In that study the authors suggested that rate of nephrolithiasis increases proportionally with follow-up time and age.…”