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Hyperferritinemia and acute kidney injury in pediatric patients receiving allogeneic hematopoietic cell transplantation
- Source :
- Pediatric Nephrology. 35:1977-1984
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Acute kidney injury (AKI) often occurs in pediatric patients who received allogeneic hematopoietic cell transplantation (HCT). We evaluated the risk and effect of HCT-related AKI in pediatric patients. We retrospectively studied the survival and renal outcome of 69 children 100 days and 1-year posttransplant in our institution in 2004–2016. Stage-3 AKI developed in 34 patients (49%) until 100 days posttransplant. The 100-day overall survival (OS) rates of patients with stage-3 AKI were lower than those without it (76.5% vs. 94.3%, P = 0.035). The 1-year OS rates did not differ markedly between 21 post-100-day survivors with stage-3 AKI and 29 without it (80.8% vs. 87.9%, P = 0.444). The causes of 19 deaths included the relapse of underlying disease or graft failure (n = 11), treatment-related events (4), and second HCT-related events (4). Underlying disease of malignancy (crude hazard ratio (HR) 5.7; 95% confidence interval (CI), 2.20 to 14.96), > 1000 ng/mL ferritinemia (crude HR 4.29; 95% CI, 2.11 to 8.71), stem cell source of peripheral (crude HR 2.96; 95% CI, 1.22 to 7.20) or cord blood (crude HR 2.29; 95% CI, 1.03 to 5.06), and myeloablative regimen (crude HR 2.56; 95% CI, 1.24 to 5.26), were identified as risk factors for stage-3 AKI until 100 days posttransplant. Hyperferritinemia alone was significant (adjusted HR 5.52; 95% CI, 2.21 to 13.76) on multivariable analyses. Hyperferritinemia was associated with stage-3 AKI and early mortality posttransplant. Pretransplant iron control may protect the kidney of pediatric HCT survivors.
- Subjects :
- Male
Nephrology
medicine.medical_specialty
Adolescent
030232 urology & nephrology
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Malignancy
Risk Assessment
Severity of Illness Index
Gastroenterology
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
Internal medicine
Humans
Transplantation, Homologous
Medicine
Child
Proportional Hazards Models
Retrospective Studies
Kidney
business.industry
Hazard ratio
Hematopoietic Stem Cell Transplantation
Acute kidney injury
Acute Kidney Injury
medicine.disease
Survival Rate
Transplantation
Regimen
medicine.anatomical_structure
Child, Preschool
Hematologic Neoplasms
Cord blood
Ferritins
Pediatrics, Perinatology and Child Health
Female
Hyperferritinemia
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 1432198X and 0931041X
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Pediatric Nephrology
- Accession number :
- edsair.doi.dedup.....7a1efc14948d0a180026719787612f16