Acute Kidney Injury Is Independently Associated With All-Cause Mortality Following Hematopoietic Stem Cell Transplantation

Abstract

THE AIM.To determine clinical value of acute kidney injury (AKI) in the setting of allogeneic hematopoietic stem cell transplantation (HSCT) for mortality along postransplant period.PATIENTS ANDMETHODS.Ninety hematopoietic stem cell transplantat (HSCT) recipients (46 males, 44 females) were enrolled in the observational prospective study. Clinical and laboratory data were monitored and assessed 7 days prior to HSCT (week 0), on the posttransplant weeks 1, 2, 3, 4 and 5. AKI was diagnosed according to KDIGO (Kidney Disease Improving Global Outcomes) guidelines. All-cause mortality was registered along 1 year of posttransplant period. AKI associations with death risk were estimated in cumulative survival analysis and Cox multivariate regression models adjusted for other confounders.RESULTS.AKI was diagnosed in 67 (74%) out of 90 patients. The majority of patients (84%) suffered from AKI 1 stage (KDIGO). AKI 2+3 stage (KDIGO) was found in 16% of patients. Renal replacement therapy was used in 4 (6%) patients with AKI. Cumulative survival rate following HSCT reached 75%. 28 deaths (31%) were registered within 1 year following HSCT. AKI was associated with lower cumulative survival following HSCT. AKI was independently associated with the risk of death according to multivariate Cox regression analyses adjusted for other confounders.CONCLUSION. AKI may be considered as a significant clinical predictor of unfavorable allogeneic HSCT outcome, taking into account its independent association with increased risk of posttransplant all-cause mortality.