Abstract

INTRODUCTION

Acute kidney disease is an important complication of allogeneic hematopoietic stem cell transplantation. The aim of this retrospective study was to identify major risk factors for acute kidney disease in hematopoietic stem cell transplantation and its effect on patients survival.

METHODS

This study was a retrospective review of 77 patients with allogeneic hematopoietic stem cell transplantation at our department from January 2007 to October 2015.

RESULTS

Acute kidney disease developed in 25 of 77 patients (32.5%). The median time to development of acute kidney disease after transplantation was 30 days. Univariate analysis showed that baseline serum gamma-glutamyl transpeptidase level, amphotericin B use and cyclosporine level were associated with the development of acute kidney disease. Logistic regression multivariate analysis showed that amphotericin B use, cytomegalovirus reactivation, conditioning regimen and cyclosporine level were an independent risk factor for acute kidney disease. Mortality and non-relapse mortality rates were higher in patients with acute kidney disease than in those without acute kidney disease. In Kaplan-Meier analysis, median survival was 18.4 months in patients without acute kidney disease and 12.2 months in patients with acute kidney disease.

DISCUSSION AND CONCLUSION

Acute kidney disease has a poor prognosis in hematopoietic stem cell transplantation and conditioning regimen, cytomegalovirus reactivation, amphotericin B use and particularly cyclosporine level are independent risk factors in the development of acute kidney disease in hematopoietic stem cell transplantation recipients.