| dc.description.abstract | Background This study aimed to determine incidence of kidney complications in pediatric allogeneic hematopoietic stem
cell transplantation (HSCT) patients.
Methods Pediatric allogeneic HSCT patients were included. Post-transplantation urinary system complications were collected
from medical records and glomerular filtration rates at last visit compared with clinical parameters. Additionally, 24-h
ambulatory blood pressure monitoring was performed.
Results The study included 165 pediatric patients. Acute kidney injury (AKI) developed in 125 (75.8%) patients of whom
54 (43.2%) had stage 1, 36 (28.8%) stage 2, and 35 (28%) stage 3 AKI. Primary malignant disease and viral infection post-
HSCT were associated with increased risk of AKI (OR: 4; 95%CI: 1.2–13, p = 0.022 and OR: 2.9; 95%CI: 1.2–6.8, p =
0.014, respectively). Mean duration of post-HSCT follow-up was 4.4 ± 2.5 years, during which time 8 patients had chronic
kidney disease (CKD) (stage 1, 4 patients; stage 2, 3 patients; stage 3, 1 patient). CKD incidence was higher in patients in
whom stem cell product was bone marrow + cord blood and mobilized peripheral blood, compared to bone marrow alone
(40–37.5% versus 5.1%, p = 0.002). Based on 24-h ABPM, 14.7% and 7.4% of patients with normal office blood pressure
had pre-hypertension and hypertension, respectively. In patients with albuminuria/severe albuminuria, daytime and nighttime
systolic SDS scores were higher than those without albuminuria/severe albuminuria (p = 0.010 and p = 0.004, respectively).
Conclusions Incidence of AKI is higher in pediatric HSCT patients with primary malignant disease and those with documented
viral infection. Our study highlights the beneficial role of 24-h ABPM as a routine part of standard care of pediatric
HSCT recipients. | tr_TR |
