The significant impact of acute kidney injury on CKD in patients who survived over 10 years after myeloablative allogeneic SCT

• Published in: Bone marrow transplantation (Basingstoke) Vol. 48; no. 1; pp. 80 - 84
• Main Authors: Shimoi, T, Ando, M, Munakata, W, Kobayashi, T, Kakihana, K, Ohashi, K, Akiyama, H, Sakamaki, H
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.01.2013; Nature Publishing Group
• Subjects: 631/250/1904; 631/532/1542; 692/699/1585/104; 692/699/1585/4; Acute Kidney Injury - epidemiology; Acute Kidney Injury - etiology; Acute Kidney Injury - physiopathology; Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow; Bone marrow transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; Cell Biology; Chronic kidney failure; Cohort Studies; Creatinine; Diagnosis; Female; Follow-Up Studies; Glomerular filtration rate; Hematology; Hemopoiesis; Humans; Incidence; Injuries; Internal Medicine; Japan - epidemiology; Kidney - physiopathology; Kidney diseases; Kidneys; Longitudinal Studies; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Nephrology. Urinary tract diseases; original-article; Physiological aspects; Public Health; Regression analysis; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - physiopathology; Retrospective Studies; Risk Factors; Severity of Illness Index; Stem cell transplantation; Stem Cell Transplantation - adverse effects; Stem Cells; Survival; Survival Analysis; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Homologous; Urinary system involvement in other diseases. Miscellaneous; Young Adult; Japan; acute kidney injury; TBI; GVHD; estimated glomerular filtration rate; Kidney disease; Human; Immunopathology; Graft versus host disease; Total body irradiation; Urinary system disease; Hematology; Acute kidney injury; Chronic kidney disease; Radiotherapy; Glomerular filtration rate; Nephropathy; Treatment; Allogeneic hematopoietic stem cell transplantation; Renal failure; Graft; Complication; Myelosuppression
• ISSN: 0268-3369; 1476-5365; 1476-5365
• DOI: 10.1038/bmt.2012.85

There are no well-defined studies of chronic kidney disease (CKD) among long-term survivors after hematopoietic SCT. A retrospective longitudinal study was conducted to characterize CKD in 77 subjects that had undergone myeloablative allogeneic SCT, all of whom had their serum creatinine (Cr) levels followed-up during the 10-year period after SCT. Their mean (range) survival time was 14.4 (10.5–20.2) years. CKD was defined as a persistent decrease in the Cr-based estimated glomerular filtration rate to below 60 mL/min/1.73 m 2 . Acute kidney injury (AKI) was defined as an increase in Cr within the first 100 days after SCT, and its severity was classified into three stages according to the AKIN criteria. Kaplan–Meier and Cox proportional hazards regression analyses evaluated the association between AKI and the incidence of CKD. The cumulative incidence of CKD increased over time and reached 34% at 10 years. After adjusting for known risks for post-SCT CKD, each AKIN stage was strongly associated with the incidence of CKD. The incidence of CKD probably increases over time among subjects who are alive at >10 years after SCT. This study places a new emphasis on AKI as an important risk factor for CKD in post-SCT subjects.