دورية أكاديمية
Acute kidney injury in children with haematological malignancy: a territory-wide study.
العنوان: | Acute kidney injury in children with haematological malignancy: a territory-wide study. |
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المؤلفون: | Lam SY; Paediatric Nephrology Centre, Hong Kong Children's Hospital, Kowloon City, Hong Kong., Chan EY; Paediatric Nephrology Centre, Hong Kong Children's Hospital, Kowloon City, Hong Kong. eugene.chan@ha.org.hk., Cheng FWT; Haematology and Oncology Centre, Department of Paediatric and Adolescent Medicine, Hong Kong Children's Hospital, Kowloon City, Hong Kong., Ma ALT; Paediatric Nephrology Centre, Hong Kong Children's Hospital, Kowloon City, Hong Kong., Ha SY; Haematology and Oncology Centre, Department of Paediatric and Adolescent Medicine, Hong Kong Children's Hospital, Kowloon City, Hong Kong. |
المصدر: | Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2023 Nov; Vol. 38 (11), pp. 3823-3833. Date of Electronic Publication: 2023 May 23. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 8708728 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-198X (Electronic) Linking ISSN: 0931041X NLM ISO Abbreviation: Pediatr Nephrol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Berlin : Springer International Original Publication: Berlin : Springer International, c1987- |
مواضيع طبية MeSH: | Acute Kidney Injury*/epidemiology , Acute Kidney Injury*/etiology , Acute Kidney Injury*/therapy , Hematologic Neoplasms*/complications , Hematologic Neoplasms*/epidemiology , Hematologic Neoplasms*/therapy, Humans ; Child ; Child, Preschool ; Adolescent ; Retrospective Studies ; Kidney ; Treatment Outcome ; Risk Factors |
مستخلص: | Background: In onco-nephrology, data on acute kidney injury (AKI) among children with haematological malignancies are scarce. Methods: A retrospective cohort study of all patients in Hong Kong diagnosed with haematological malignancies from 2019 to 2021 before 18 years of age, was conducted to investigate the epidemiology, risk factors and clinical outcomes of AKI during the first year of treatment. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: We included 130 children with haematological malignancy at median age of 9.4 years (IQR, 3.9-14.1). Of these patients, 55.4% were acute lymphoblastic leukemia (ALL), 26.9% were lymphoma and 17.7% were acute myeloid leukemia (AML). Thirty-five patients (26.9%) developed 41 AKI episodes during the first year of diagnosis, corresponding to 32 episodes per 100-patient-year. A total of 56.1% and 29.2% of the AKI episodes occurred during induction and consolidation chemotherapy respectively. Septic shock (n = 12, 29.2%) was the leading cause of AKI; 21 episodes (51.2%) were stage 3 AKI; 12 episodes (29.3%) were stage 2 AKI; and 6 patients required continuous kidney replacement therapies. Tumor lysis syndrome and impaired baseline kidney function were significantly associated with AKI on multivariate analysis (P = 0.01). History of AKI was associated with chemotherapy postponement (37.1% vs. 16.8%, P = 0.01), worse 12-month patient survival (77.1% vs. 94.7%, log rank P = 0.002) and lower disease remission rate at 12-month (68.6% vs. 88.4%, P = 0.007), compared to patients without AKI. Conclusion: AKI is a common complication during treatment of haematological malignancies which is associated with worse treatment outcomes. A regular and dedicated surveillance program for at-risk patients should be studied in children with haematological malignancies for prevention and early detection of AKI. A higher resolution version of the Graphical abstract is available as Supplementary information. (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.) |
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فهرسة مساهمة: | Keywords: Acute kidney injury; Children; Haematological malignancy; Kidney failure; Leukemia; Lymphoma |
تواريخ الأحداث: | Date Created: 20230523 Date Completed: 20230922 Latest Revision: 20231201 |
رمز التحديث: | 20231201 |
DOI: | 10.1007/s00467-023-06010-z |
PMID: | 37219640 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1432-198X |
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DOI: | 10.1007/s00467-023-06010-z |