Epidemiological Studies Of Hematopoietic Stem Cell Transplantation Patients With Acute Kidney Injury

Objective This is a retrospective analysis of clinical data of hematopoietic stem celltransplantation (HSCT) patients develop acute kidney injury(AKI), summarizethemorbidity, risk factors and prognosis, in order to improve the early diagnosis andtreatment of AKI patients, also improve the prognosis of patients with AKI.Methods453patients who received HSCT in January2010-May2012in the first affiliatedhospital of suchow university were studied retrospectively to identify the risk factors forAKI, exclude the patients whose information were incomplete. The renal function beforeand100days after the transplantation, preparative conditioning and the complicationswere observed, and all patients were followed for one year. The407patients included inthe research were divided into no AKI(NAKI) and AKI group (stage Ⅰ-risk, stage Ⅱ-injury and stage Ⅲ–failure), according to the standard of AKI network (AKIN). Thedifference between the two groups was compared by χ2test, then the logistic regressionanalysis to filter out AKI risk factors.Results1.Among the407cases, NAKI was323cases and AKI group was84cases, whichcomposed by AKIⅠ stage of59cases, AKI Ⅱ stage of10cases and AKI Ⅲstage of15patients. The AKI incidence rate is20.6%.2.Logistic regression analysis for risks for developing AKI revealed an episode ofincomplete HLA-match, myeloablative conditioning or complications(sepsis or HVOD)as an independent risk factor of AKI (P<0.05). Further analysis showed that aGVHD andhemorrhagic cystitis (HC) were associated with severe stage of AKI.3.1year later, among the108died patients, there was64NAKI patients,26AKI stage-Ⅰ patients,6AKI stage-Ⅱ patients and12AKI stage-Ⅲ patients.1yearmortality of HSCT patients with AKI was26.5%, and mortality rate gradually increasedwith the severity of AKIconclusionsAKI was a common complication of HSCT patients, human leukocyte antige n(HLA) do not match, myeloablative conditioning or complications （sepsis andHVOD） were independent risk factors of AKI in HSCT patients. The incidence of AKIafter HSCT was20.6%. The mortality of HSCT patients with AKI was significantlyhigher than NAKI patients, and the mortality increased with the severity of AKI. So AKIhad an important effect on one-year mortality of HSCT patients.