Hyperferritinemia and acute kidney injury in pediatric patients receiving allogeneic hematopoietic cell transplantation

Autor:	Shouichi Ohga, Kei Nishiyama, Mari Kurokawa, Akira Shiraishi, Hazumu Nagata, Utako Oba, Noriyuki Kaku, Yuhki Koga, Takashi Imai, Satoshi Honjo, Masataka Ishimura, Katsuhide Eguchi
Rok vydání:	2020
Předmět:	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
Zdroj:	Pediatric Nephrology. 35:1977-1984
ISSN:	1432-198X 0931-041X
Popis:	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.
Databáze:	OpenAIRE
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