Clinical Analysis Of Acute Kidney Injury After Allogeneic Hematopoietic Stem Cell Transplantation In Single-Center Children

Objective: To analyze the risk factors and clinical characteristics of acute kidney injury after allogeneic hematopoietic stem cell transplantation in children.Methods: A total of 235 children who received hematopoietic stem cell transplantation in Wuhan Children’s Hospital from August 2016 to March 2022 were analyzed retrospectively,of which 220 were included in this study.Collect clinical data: age,sex,primary disease before transplantation,transplantation method,pretreatment regimen,serum creatinine before transplantation,maximum serum creatinine within 100 days after transplantation,time and grade of acute kidney injury and transplantation-related complications: sepsis,acute graft-versus-host disease,thrombotic microangiopathy,hepatic sinusoidal space obstruction syndrome,hemorrhagic cystitis,cytomegalovirus infection,EB virus infection,cytomegalovirus infection.The clinical characteristics and risk factors of acute kidney injury were analyzed by univariate and multivariate logistic regression.Results: A total of 220 children were included in this study,including 127 males(57.7%)and 93 females(42.3%).The average age was 8 years old and 2 months(8months-15 years old and 11 months).The total incidence was 69%(78 cases of acute kidney injury stage Ⅰ,51 cases of acute kidney injury stage Ⅱ and 23 cases of acute kidney injury stage Ⅲ).Univariate logistic regression analysis showed that the degree of human leukocyte antigen matching(mismatch),primary disease before transplantation: hemophagocytic syndrome,post-transplantation complications including acute graft-versus-host disease,thrombotic microvascular disease,hepatic sinusoidal obstruction syndrome,hemorrhagic cystitis,cytomegalovirus infection and EB virus infection were all risk factors for acute renal injury.Multivariate logistic regression analysis showed that the degree of human leukocyte antigen matching(mismatch)and complications including acute graft-versus-host disease,thrombotic microvascular disease,hepatic sinusoidal obstruction syndrome,cytomegalovirus infection and EB virus infection were independent risk factors for acute kidney injury.Conclusion: Acute kidney injury is a common complication of allogeneic hematopoietic stem cell transplantation in children,which is closely related to the degree of human leukocyte antigen matching(mismatch),primary disease(hemophagocytic syndrome)and postoperative complications.