Kidney Recovery From Acute Kidney Injury After Hematopoietic Stem Cell Transplant: A Systematic Review and Meta-Analysis

Abstract

Patients with the recovery of kidney function after an episode of acute kidney injury (AKI) have better outcomes compared to those without recovery. The current systematic review is conducted to assess the rates of kidney function recovery among patients with AKI or severe AKI requiring kidney replacement therapy (KRT) within 100 days after hematopoietic stem cell transplant (HSCT). Methods The Ovid MEDLINE, EMBASE, and Cochrane databases were systemically searched from database inceptions through August 2019 to identify studies reporting the rates of recovery from AKI after HSCT. The random-effects and generic inverse variance methods of DerSimonian-Laird were used to combine the effect estimates obtained from individual studies. Results A total of 458 patients from eight cohort studies with AKI after HSCT were identified. Overall, the pooled estimated rates of AKI recovery among patients with AKI and severe AKI requiring KRT within 100 days were 58% (95%CI: 37%-78%) and 10% (95%CI: 2%-4%), respectively. Among patients with AKI recovery, the pooled estimated rates of complete and partial AKI recovery were 60% (95%CI: 39%-78%) and 29% (95%CI: 10%-61%), respectively. There was no clear correlation between study year and the rate of AKI recovery (p=0.26). Conclusion The rate of recovery from AKI after HSCT depends on the severity of AKI. While recovery is common, complete recovery is reported in about two-thirds of all AKI patients. The rate of recovery among those with AKI requiring renal replacement therapy (RRT) is substantially lower.

Recovery after acute kidney injury requiring kidney replacement therapy in patients with left ventricular assist device: A meta-analysis

“…Another interesting observation in our analysis is pooled incidence of kidney recovery from KRT is 50%, which is reassuring compared to kidney recovery rates of other cohorts like hematopoietic stem cell transplant (HSCT). The pooled estimated kidney recovery rates after severe AKI-KRT at 100 d among the HSCT cohort are as low as 10%[ 38 ]. This difference could be secondary to multiple factors as patients after HSCT are much sicker from underlying terminal cancer and exposed to high-dose chemotherapy or radiation.…”

ACUTE RENAL DISORDER IN PATIENTS WITH ACUTE LEUKEMIA AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION: A SERIES OF CLINICAL CASES

“…Kanduri с соавт. с участием 5114 пациентов, перенесших ТГСК, частота развития ОПП у реципиентов ТГСК составила 49,8% [3]. Наиболее часто ОПП регистрируется в первые 100 дней после ТГСК [4,5].…”