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Author(s): Luciano da Silva Selistre [sup.1] [sup.2] [sup.3] , Cécile Renard [sup.4] , Justine Bacchetta [sup.5] [sup.6] , Marie-Pierre Goutagny [sup.4] , Julie Hu [sup.4] , Vandréa Carla de Souza [...], Background Allogenic hematopoietic stem cell transplantation (aHSCT) remains the treatment of choice for some malignant hemopathies in children, albeit with the risk of long-term consequences, including chronic kidney disease (CKD). Methods In our single tertiary referral center, we retrospectively assessed the long-term renal outcome in a cohort of children and adolescents who had undergone aHSCT for malignant hemopathies between 2003 and 2017. We distinguished glomerular and tubular dysfunctions and assessed the accuracy of the most common formula(s) to estimate glomerular filtration rate (GFR) during standard clinical follow-up. Results Among the 166 patients who had received aHSCT, 61 underwent kidney functional assessment 1 to 10 years post-transplantation. Twenty-seven patients (44.3%) had a CKD with glomerular impairment, including 20 patients with a GFR < 90 mL/min/1.73 m.sup.2, and among these, 5 patients < 60 mL/min/1.73 m.sup.2. Patients with tubular signs had a significantly higher baseline GFR: 112 mL/min/1.73 m.sup.2 [100; 120] versus 102 [99.0; 112.5] for patients without kidney involvement, and 76 [61; 86] for patients with CKD (p < 0.01). Schwartz, CKiDU25, and EKFC formulas significantly overestimated mGFR, with a P30% [less than or equal to] 30%, which could lead to overlooking CKD diagnosis in this population. No patient reached kidney failure. Conclusions In conclusion, our study shows that CKD represents an important long-term sequela for children and adolescents who undergo aHSCT for malignant hemopathies, either with glomerular dysfunction or with the more insidious tubular dysfunction which could potentially impact growth. These patients could benefit from specialized long-term nephrology follow-up. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information.

Objective: To identify factors, particularly neonatal acute kidney injury, associated with an increased risk of developing chronic kidney disease (CKD) within the first 10 years of life in children with a history of prematurity and very low birth weight (VLBW)., Methods: This nested case-control study was conducted on VLBW infants (> 500 g and < 1.500 g) born between 2012 and 2022. The population (n = 119) included children who developed CKD (n = 55) and controls with normal findings (n = 64). CKD was defined by abnormal blood pressure, reduced glomerular filtration rate, or elevated urinary albumin excretion. Data on neonatal and maternal factors were analyzed using logistic regression to identify predictors of CKD., Results: Of the 267 eligible children 119 were included, with a median age of 32 months, and median gestational age and birth weight of 30 weeks and 1170 g, respectively. Children with CKD had lower birth weight Z-scores (-1.06 vs. -0.89), a higher occurrence of extrauterine growth restriction (EUGR) (72 % vs. 51 %), and an increased likelihood of maternal preeclampsia exposure. Maternal preeclampsia was identified as an independent predictor of CKD, associated with a 5 % increase in the odds of developing the condition (OR 1.05, 95 % CI 1.01-1.66)., Conclusion: Maternal preeclampsia was associated with CKD in children with a history of VLBW. This finding highlights the importance of long-term follow-up and early identification of at-risk individuals., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2025 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)