关键词: 造血干细胞移植, 急性肾损伤, 危险因素, 预后

Abstract:

【Abstract】Objective: To analyze the clinical data, risk factors and prognosis of allogeneic hematopoietic stem cell transplantation (HSCT) patients who developed acute kidney injury (AKI) in order to assist the early diagnosis and treatment of AKI patients and improve the prognosis. Methodology: The clinical data of 407 patients who received HSCT from January 2010 to December 2012 in the first affiliated hospital of Soochow University were retrospectively collected. According to the criteria of AKI network (AKIN), these patients were divided into non AKI (NAKI) group and AKI group (stage I-risk, stage II-injury and stage III- renal failure). The changes of renal function before and 100 days after HSGT, the pre-conditioning methods, and the post-transplantation complications were investigated. Each patient was followed up for one year. Spearman test and logistic regression analysis were applied for statistical analysis. Results: They were 323 cases (79.4%) of NAKI, and 84 cases (20.6%) of AKI including 59 at stage I, 10 at stage II and 15 cases at stage III. Logistic regression analysis revealed incomplete human leukocyte antigen (HLA)-match, myeloablative pre-conditioning and post-transplantation complications (sepsis or hepatic vein occlusion syndrome) as the risk factors of AKI (P<0.05). 107 patients (26.3%) including 64 patients in NAKI group, 26 patients at AKI stage I, 6 patients at AKI stage II and 11 patients at AKI stage III died one year after HSCT. The one-year mortality of HSCT patients with AKI gradually increased with the severity of AKI. Conclusion: We demonstrated that AKI was a common complication post HSCT, and incomplete HLA match, myeloablative pre-conditioning or post-HSCT complications (sepsis and hepatic venular occlusive disease) were risk factors of AKI in HSCT patients. The mortality of HSCT patients with AKI was significantly higher than that in NAKI patients, and it increased with the severity of AKI.

Key words: hematopoietic stem cell transplantation (HSCT), acute kidney injury (AKI), risk factors, prognosis