| Objective: Analysis of the incidence and risk factors of acute kidneyinjury after hematopoietic stem cell transplantation, and to explore themolecular markers for predicting early acute kidney injury.Methods: Firstly,14patients who underwent hematopoietic stem celltransplantation were observed between2013-1and2014-2from Departmentof Hematology, Second Hospital of Hebei Medical University. Therelationships between AKI in first100d post-transplantations and patients’ age,sex, medical history, basic pre-transplant liver function, kidney function, thetype of transplant, transplant conditioning regimen, GVHD and preventionprograms, VOD were analysed. Secondly, we detected the patients’ serumcreatinine and cyatatin C levels from conditioning to first100dpost-transplantation. ELISA was used to detect urinary KIM-1, NGAL, IL-18levels, The significance between these indicators and the AKI occurred wasexplored. AKI was classified according to the AKIN criteria．Results: Firstly, ten patients (71%) developed AKI at a median of14days after transplant. Allograft HSCT was performed for ten patients, ninepatients (90%) developed AKI. Autograft HSCT was include for four patientsand one patients (25%)developed AKI. Secondly, cyclosporine A,cytomegalovirus, BK virus infections were found to be the risk factors todevelopment AKI. Thirdly, serum creatinine and KIM-1, CysC, NGAL, IL-18was significantly higher in AKI group than in non-AKI group. Correlationanalysis showed there is a positive correlation between KIM-1, CysC, NGAL,IL-18and serum creatinine in the AKI group. ROC curve proved the cut-offvalue of CysC was0.745mg/L, the sensitivity and specificity were highest atthis time, respectively90%and99%. The cut-off value of IL-18was19.68ng/L, the highest sensitivity and specificity, was94%, and99% respectively. NGAL at1.079μg/L possessed highest sensitivity and specificity,respectively94%and99%. KIM-1is the highest and sensitivity specificity15.550ng/L, respectively,96%,99%.Conclusions: AKI is a common complications after hematopoieticstem cell transplantation,The frequency of AKI in our patients with HSCTremained high. cyclosporine A, cytomegalovirus, BK virus infections werefound to be the risks factors to development AKI. KIM-1, NGAL, IL-18,CystatinC Can become the diagnostic indicator for evaluation of acute kidneyinjury in hematopoietic stem cell transplant recipients．... |
