Incidence of acute kidney disease after receiving hematopoietic stem cell transplantation: a single-center retrospective study
Incidence of acute kidney disease after receiving hematopoietic stem cell transplantation: a single-center retrospective study
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DOI：
10.7717/peerj.6467
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发表时间：
2019-02-28
期刊：
影响因子：
2.7
通讯作者：
Tsubaki, Kazuo
中科院分区：
文献类型：
--
作者：
Mima, Akira;Tansho, Kousuke;Tsubaki, Kazuo
背景资料：造血干细胞移植（HSCT）是血液病患者的重要治疗手段，但既往研究表明，HSCT后急性肾损伤（阿基）较为常见。阿基可增加死亡率并诱发不良反应，包括慢性肾脏疾病的发展。据报道，与HSCT相关的阿基发生率差异很大，因为采用了几种阿基定义。急性肾脏病（AKD）是一个新的概念，可以在临床上定义阿基和肾小球滤过率（GFR）状态持续下降。我们进行了一项回顾性队列研究，以确定AKD的发病率后HSCT.Methods：本研究包括108例患者年龄在16岁和70岁之间接受HSCT。在本研究中，AKD包括阿基或GFR亚急性降低的临床状况。阿基是根据《肾脏疾病：改善全球结局》指南基于血清肌酸酐定义的。但是，未纳入尿量数据来定义阿基，因为数据库缺少其中一些数据。使用Mann-Whitney U检验进行组间比较。结果：17例患者（15.7%）发生急性肾脏疾病。AKD和非AKD患者之间在ABO血型不合HSCT（p = 0.001）和HSCT后急性移植物抗宿主病（GVHD）发生率方面存在显著差异（p < 0.001）。HSCT后AKD患者和无AKD患者的100天总生存率分别为70.6%和79.8%（p = 0.409）。讨论：ABO血型不合HSCT和HSCT后急性GVHD是AKD发病的危险因素。然而，我们没有发现HSCT后AKD与死亡率之间的显著相关性。
Background: Previous reports have shown that acute kidney injury (AKI) is common after hematopoietic stem cell transplantation (HSCT), which is a crucial treatment for patients with hematological disorders. AKI could increase mortality and induce adverse effects including the development of chronic kidney disease. The incidence of AKI in association with HSCT reportedly varies significantly because several definitions of AKI have been adopted. Acute kidney disease (AKD) is a new concept that can clinically define both AKI and persistent decreases in glomerular filtration rate (GFR) state. We conducted a retrospective cohort study to determine the incidence of AKD after HSCT.Methods: This study included 108 patients aged between 16 and 70 years undergoing HSCT. In this study, AKD included clinical condition of AKI or subacute decreases in GFR. AKI was defined according to the Kidney Disease: Improving Global Outcomes guidelines based on serum creatinine. However, urine output data were not included to define AKI because the database lacked some of these data. Comparisons were made between groups using the Mann-Whitney U test.Results: Acute kidney disease occurred in 17 patients (15.7%). There were si gnificant differences between the AKD and non-AKD with respect to ABO-incompatible HSCT (p = 0.001) and incidence of acute graft versus host disease (GVHD) after HSCT (p < 0.001). The 100-day overall survival of patients with AKD and without AKD after HSCT was 70.6% and 79.8%, respectively (p = 0.409).Discussion: ABO-incompatible HSCT and acute GVHD after HSCT were risk factors for the incidence of AKD. However, we could not find a significant association between AKD after HSCT and mortality.