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Acute Kidney Injury in Pediatric Patients Receiving Allogeneic Hematopoietic Cell Transplantation: Incidence,Risk Factors,and Outcomes
Authors:Kyung-Nam Koh  Anusha Sunkara  Guolian Kang  Amanda Sooter  Daniel A. Mulrooney  Brandon Triplett  Ali Mirza Onder  John Bissler  Lea C. Cunningham
Abstract: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?
Keywords:Acute kidney injury  Allogeneic hematopoietic stem cell transplantation  Children  Renal replacement therapy
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