Hematopoietic stem cell transplantation and acute kidney injury in children: A comprehensive review

Raina, Rupesh; Herrera, Nicholas; Krishnappa, Vinod; Sethi, Sidharth Kumar; Deep, Akash; Kao, Wei-Ming; Bunchman, Timothy E.; Abu‐Arja, Rolla

doi:10.1111/petr.12935

Cited by 36 publications

(33 citation statements)

References 84 publications

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“…Many post-transplant events such as lung toxicity, sepsis, cardiac involvement, admission to an intensive care unit, SOS, and acute GVHD are previously described risk factors for renal events in various pediatric and adult studies [1,2,24]. Among them, SOS is a repeatedly described risk factor [16,17,26,[30][31][32].…”

Section: Discussionmentioning

confidence: 97%

“…Acute kidney injury (AKI) is a well-described complication after hematopoietic cell transplantation (HCT), affecting 20% to 84% of transplant recipients [1][2][3][4]. HCT is a multistep process including many treatments that can cause renal insults, such as conditioning regimens composed of intensive chemotherapy or radiation, nephrotoxic immunosuppressive agents, and prophylactic or therapeutic anti-infectious agents.…”

Section: Introductionmentioning

confidence: 99%

“…AKI is associated with mortality and increased risk of chronic kidney disease in transplant survivors [1,2,[4][5][6][7]. In addition, AKI can limit the use of many medications, thereby complicating post-transplant management.…”

Section: Introductionmentioning

confidence: 99%

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Acute Kidney Injury in Pediatric Patients Receiving Allogeneic Hematopoietic Cell Transplantation: Incidence, Risk Factors, and Outcomes

Koh

Sunkara

Kang

et al. 2018

Biology of Blood and Marrow Transplantation

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Acute kidney injury (AKI) is a common adverse event after hematopoietic cell transplantation (HCT). AKI is associated with early death or chronic kidney disease among transplant survivors. However, large-scale pediatric studies based on standardized criteria are lacking. We performed a retrospective analysis of 1057 pediatric patients who received allogeneic HCT to evaluate the incidence and risk factors of AKI according to AKI Network criteria within the first 100 days of HCT. We also determined the effect of AKI on patient survival. The 100-day cumulative incidences of all stages of AKI, stage 3 AKI, and AKI requiring renal replacement therapy (RRT) were 68.2% ± 1.4%, 25.0% ± 1.3%, and 7.6% ± .8%, respectively. Overall survival at 1 year was not different between patients without AKI and those with stage 1 or 2 AKI (66.1% versus 73.4% versus 63.9%, respectively) but was significantly different between patients without AKI and patients with stage 3 AKI with or without RRT requirement (66.1% versus 47.3% versus 7.5%, respectively; P < .001). Age, year of transplantation, donor type, sinusoidal obstruction syndrome (SOS), and acute graft-versus-host disease (GVHD) were independent risk factors for stages 1 through 3 AKI. Age, donor, conditioning regimen, number of HCTs, SOS, and acute GVHD were independent risk factors for AKI requiring RRT. Our study revealed that AKI was a prevalent adverse event, and severe stage 3 AKI, which was associated with reduced survival, was common after pediatric allogeneic HCT. All patients receiving allogeneic HCT, especially those with multiple risk factors, require careful renal monitoring according to standardized criteria to minimize nephrotoxic insults.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Acute Kidney Injury in Pediatric Patients Receiving Allogeneic Hematopoietic Cell Transplantation: Incidence, Risk Factors, and Outcomes

Koh

Sunkara

Kang

et al. 2018

Biology of Blood and Marrow Transplantation

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“…Among them, acute kidney injury (AKI) has become one of the major challenges, as it is an independent predictive factor for patient survival and progression to chronic kidney disease (CKD). 1,2 Although there are many reviews on HSCT, few of them concern the pediatric population, [3][4][5] and none of them concentrate on the nephrological aspects of HSCT.…”

Section: Current Methods Of Assessing Kidney Function Following Hematmentioning

confidence: 99%

Markers of acute kidney injury in children undergoing hematopoietic stem cell transplantation

Augustynowicz¹,

Bargenda-Lange²,

Kałwak³

et al. 2019

Adv Clin Exp Med

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Acute kidney injury (AKI), one of the major complications in children undergoing hematopoietic stem cell transplantation (HSCT), is an independent predictor of the patient's survival and a prognostic factor of progression to chronic kidney disease (CKD). Despite the multifaceted role of AKI, its early diagnosis in the course of HSCT remains a challenge. These difficulties may result from the inefficiency of traditional methods used to assess kidney function, like serum creatinine or estimated glomerular filtration rate. Moreover, the list of potential AKI markers tested in HSCT conditions is limited and does not involve indexes evaluated in the pediatric population. This review summarizes current knowledge on the pathophysiology of AKI developing in the course of HSCT; presents well-known markers of AKI that are potentially applicable in children who have undergone HSCT; discusses the role of new markers in diagnosing AKI and predicting the renal outcome in children undergoing HSCT; and analyzes the prospects for the use of new tools for assessing kidney injury in everyday clinical practice.

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“…HSCT can generate sustained damage to a variety of organs in children undergoing the procedure. Cardiac, renal, and pulmonary damage have been well described in pediatric HSCT recipients [6][7][8][9]. Previous studies have shown that children undergoing HSCT can also experience various impairments that can impact school performance [10,11].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Ototoxicity Following Hematopoietic Stem Cell Transplantation in Pediatric Patients

Gertson

Hayashi

Trinkaus

et al. 2020

Biology of Blood and Marrow Transplantation

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The use of hematopoietic stem cell transplantation (HSCT) is increasing for a variety of diseases. Ototoxicity from this procedure has not been extensively studied. A retrospective chart review examined 275 patients from this institution who underwent HSCT between January 1, 2007, and April 30, 2017. Data extracted included therapy before HSCT and the subsequent course of transplantation. Evaluable patients had complete medical records and interpretable audiograms available. Ototoxicity constituted significant threshold changes from baseline or changes in International Society of Pediatric Oncology/Boston Ototoxicity Grading Scale (SIOP) grade comparing audiogram results just before HSCT with those following the transplantation procedure. A total of 147 patients were evaluable. Ototoxicity was observed in 10.2% of the patients. Higher SIOP grade before HSCT was significantly associated with a higher risk of post-transplantation ototoxicity (P < .01). Previous cisplatin treatment (P < .0001), but not carboplatin or radiation treatment, was also associated with ototoxicity. Patients with a solid tumor or brain tumor (P < .0001) and those who received an autologous transplant (P = .0002) were also at increased risk. No post-transplantation event was significantly associated with ototoxicity. Ototoxicity affects a significant percentage of patients undergoing HSCT, and careful monitoring is needed to identify patients impacted by this procedure.

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Hematopoietic stem cell transplantation and acute kidney injury in children: A comprehensive review

Cited by 36 publications

References 84 publications

Acute Kidney Injury in Pediatric Patients Receiving Allogeneic Hematopoietic Cell Transplantation: Incidence, Risk Factors, and Outcomes

Acute Kidney Injury in Pediatric Patients Receiving Allogeneic Hematopoietic Cell Transplantation: Incidence, Risk Factors, and Outcomes

Markers of acute kidney injury in children undergoing hematopoietic stem cell transplantation

Prevalence of Ototoxicity Following Hematopoietic Stem Cell Transplantation in Pediatric Patients

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