论文部分内容阅读
Background and Objective: Alloganeic hematopoietic cell transplantation(allo-HSCT)is a potent procedure for the treatment of hematologic diseases,yet it is associated with high risks of treatment-related complications.Except for transplant-related organ toxicities,renal insufficiencies which emerge earlier significantly limit patientslong survival.To analyze risk factors for acute kidney injury(AKI),we conducted a retrospective cohort study of 96 patients undergoing HSCT.Methods:During the first 100 days after allo-HSCT,all patients were evaluated for renal function by measuring serum creatinine clearance and glomerular filtration rate(GFR)with a classification below: Grade 0(< 25%,decline in craatinine clearance),Grade 1(≥25% decline in creatinine clearance but < 2-fold increase in serum creatinine),Grade 2(≥2-fold dse in serum creatinine but no need for dialysis),and Grade 3(≥2-fold rise in serum creatinine and need for dialysis).Cox regression model was used to calculate the hazard ratios(HRs)of demographic data,clinical variablea,and risk factors for AKI.Results: Twenty-eight(29.2%)patients occurred Grades 1-3 renal dysfunction(Grade1,14 patients; Grade 2,12 patients; Grade 3,2 patients),and ratios of early kidney injury increased in high-risk malignancy group(HR=2.945,95% confidence interval(Cl)=1.293-6.421),patients treated with myeloablative conditioning regimen(HR=2.463,95% Cl=1.757-4.320),and patients with acute GVHD(HR=3.553,95% Cl=1.809-6.978),sepsis(HR=3.215,95% Cl=1.189-6.333),or hepatic veno-occlusive disease(VOD)(HR=3.487,95% Cl=1.392-6.524).Whereas,HLA histocompatibility showed no striking increased risk for acute renal injury(HR=1.684,95%Cl=0.648-4.378).The survival rate was lower in patients with severe nephrotoxicity(21.4%)than in patients without nephrotoxicity(70.6%)(P=0.001).Conclusions:Nephrotoxicity is the primary risk factor for AKI,severely impacting on survival.Sorts of risk factors mentioned will be useful for evaluation for kidney function of patients undergoing allo-HSCT.