Incidence and predictors of delayed chronic kidney disease in long-term survivors of hematopoietic cell transplantation.
Incidence and predictors of delayed chronic kidney disease in long-term survivors of hematopoietic cell transplantation.
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DOI：
10.1002/cncr.23773
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发表时间：
2008-10-01
期刊：
影响因子：
6.2
通讯作者：
Bhatia, Smita
中科院分区：
文献类型：
--
作者：
Choi, Michael;Sun, Can-Lan;Kurian, Seira;Carter, Andrea;Francisco, Liton;Forman, Stephen J.;Bhatia, Smita
关键词：
本研究描述了1976年至1997年间因恶性血液病或再生障碍性贫血接受造血细胞移植（HCT）并存活至少一年的1190例成人HCT存活者发生迟发性慢性肾病（CKD）的风险。CKD定义为血清肌酐持续升高，导致肾小球滤过率<60 mL/min/1.73 m2，持续3个月或更长时间。HCT时的中位年龄为35.0岁（范围：18.1 - 68.6岁），HCT后的中位随访时间为7.1年（范围：1 - 24.3年）。确定了60例CKD患者，5年时的累积发生率为4.4%（自体HCT：3.8%;匹配的同胞HCT：4.5%;无关供体HCT：10.0%;与自体HCT相比，p=0.09）。HCT时的年龄较大（每5年增量的相对风险[RR]，1.33; 95% CI，1.2-1.5）;暴露于环孢霉素而不使用他克莫司（RR=1.90，95% CI，1.1 - 3.4）或他克莫司（RR=4.59，95% CI，1.8至11.5）;和多发性骨髓瘤的初步诊断（RR=2.51，95% CI，1.1至5.6）与迟发性CKD的风险增加相关。这项研究确定了CKD风险增加的HCT亚群，为脆弱患者的适当长期随访奠定了基础。
This study describes the risk of delayed chronic kidney disease (CKD) in 1190 adult hematopoietic cell transplantation (HCT) survivors who underwent HCT for hematologic malignancies or aplastic anemia between 1976 and 1997, and survived at least one year. CKD was defined as a sustained elevation of serum creatinine inferring a glomerular filtration rate of <60 mL/min/1.73 m2 for three months or longer. Median age at HCT was 35.0 years (range, 18.1 to 68.6 years) and median length of follow-up, 7.1 years from HCT (range, 1 to 24.3 years). Sixty patients with CKD were identified, resulting in a cumulative incidence of 4.4% at 5 years (autologous HCT: 3.8%; matched sibling HCT: 4.5%; unrelated donor HCT: 10.0%; p=0.09 compared to autologous HCT). Older age at HCT (relative risk [RR] per five-year increment, 1.33; 95% CI, 1.2-1.5); exposure to cyclosporine without tacrolimus (RR=1.90, 95% CI, 1.1 to 3.4) or with tacrolimus (RR=4.59, 95% CI, 1.8 to 11.5); and a primary diagnosis of multiple myeloma (RR=2.51, 95% CI, 1.1 to 5.6) were associated with an increased risk of delayed CKD. This study identifies sub-populations of HCT at increased risk for CKD, setting the stage for appropriate long-term follow-up of vulnerable patients.
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影响因子：
4.8
作者：
Hingorani, S.;Guthrie, K. A.;McDonald, G. B.
通讯作者：
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DOI：
10.1016/j.ijrobp.2006.02.021
发表时间：
2006-07-15
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作者：
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影响因子：
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作者：
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