A systematic review of acute kidney injury in pediatric allogeneic hematopoietic stem cell recipients

Pediatr Transplant. 2015 Aug;19(5):460-70. doi: 10.1111/petr.12483. Epub 2015 May 12.

Abstract

The process of allogeneic HSCT in children is associated with frequent AKI and mortality, but the epidemiology is not widely reported. The aim of this review was to summarize the available evidence on incidence, risk factors, timing, and prognosis of AKI in children following HSCT. We systematically reviewed all observational studies reporting incidence and outcomes of AKI in pediatric allogenic HSCT recipients. The minimum criteria for AKI were defined as an increase in sCr ≥ x1.5 or urine output ≤0.5 mL/kg/min over six h. Medline and Embase were searched until March 2014. From 993 electronic records, five were eligible for inclusion (n = 571 patients). The average incidence of AKI within the first 100 days following HSCT was 21.7% (range 11-42%), and the average time of onset was 4-6 wk post-transplant. Risk factors for AKI included cyclosporine toxicity, amphotericin B and foscarnet, SOS, and having a mismatched donor. There were conflicting reports on whether AKI was associated with the development of CKD. AKI is a common and potentially life-threatening complication following HSCT in children. Further quality observational studies are needed to accurately determine the epidemiology and prognosis of AKI in this population.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Acute Kidney Injury / complications*
  • Acute Kidney Injury / etiology*
  • Adolescent
  • Amphotericin B / adverse effects
  • Biomarkers / urine
  • Child
  • Cyclosporine / toxicity
  • Foscarnet / adverse effects
  • Glomerular Filtration Rate
  • Graft vs Host Disease
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Incidence
  • Prognosis
  • Risk Factors
  • Transplantation, Homologous / adverse effects
  • Treatment Outcome

Substances

  • Biomarkers
  • Foscarnet
  • Amphotericin B
  • Cyclosporine