Pretransplant Predictors and Posttransplant Sequels of Acute Kidney Injury after Allogeneic Stem Cell Transplantation
Pretransplant Predictors and Posttransplant Sequels of Acute Kidney Injury after Allogeneic Stem Cell Transplantation
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DOI：
10.1016/j.bbmt.2010.07.010
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发表时间：
2011-03-01
影响因子：
4.3
通讯作者：
Kurokawa, Mineo
中科院分区：
文献类型：
--
作者：
Kagoya, Yuki;Kataoka, Keisuke;Kurokawa, Mineo
急性肾损伤（阿基）是异基因造血干细胞移植（SCT）后常见的并发症。尽管已经报道了阿基的各种危险因素，但移植前合并症对阿基发生率的影响尚未得到充分研究。我们对2001年至2009年期间接受清髓性或非清髓性SCT的207例连续患者进行了回顾性分析，使用造血细胞移植特异性合并症指数（HCT-CI）作为移植前合并症的代表。根据风险、损伤、衰竭、损失和终末期肾病（步枪）标准，158例患者（76.3%）在SCT后100天内发生阿基，92例患者（44.4%）在SCT后100天内发生重度阿基（步枪1级或F级）。HCT-CI评分为0、1-2和>= 3的患者100天内重度阿基的累积发生率分别为21.3%、48.8%和73.9%。在多变量分析中，HCT-CI与重度阿基独立相关（HCT-CI 1-2：校正的风险比[HR] 2.42，P= 3：校正的HR 4.69，P = 0.001）。
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 1 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= 3: adjusted HR 4.69, P