HEMATOPOETİK KÖK HÜCRE NAKLİ YAPILAN OLGULARIN UZUN DÖNEM RENAL FONKSİYONLARININ DEĞERLENDİRİLMESİ
Project no. 20975 · Status: Kapanmış · 2020
Summary
With the increase in the use of Hematopoietic Stem Cell Transplantation (HSCT) treatment method, it is associated with an increase in long-term complications. In this study, we wanted to determine the risk factors that affect the long-term renal functions, the frequency of development of chronic kidney disease, and the long-term renal functions of pediatric patients who underwent allogeneic HSCT. 94 pediatric patients who underwent allogeneic HSCT in the Bone Marrow Transplantation Unit of Ege University Faculty of Medicine, Department of Pediatrics and were at least in their second year after transplantation, and whose data could be accessed, were included in the study. Primary diagnosis of the cases, pre-transplant renal function tests, preparation regimen, post-transplant infections, donor compatibility, transplantation type, duration of immunosuppressive treatment, Graft Versus Host Disease (GVHD) development and treatments for it, presence of acute kidney injury (AKI). The intensive care hospitalization history was obtained from the patient files. Renal function tests were obtained retrospectively from patient files before and after transplantation, and annually in the second year after transplantation. In our study, 9 (9.4%) of 94 cases were evaluated as chronic kidney disease (CKD) according to Schwartz. No relationship was found between age, development of GVHD, AKI, Total body irradiation (TVI), sepsis, nephrotoxic drug intake, venoocclusive disease (VOD), hemorrhagic cystitis, Cytomegalovirus (CMV) infection, transplant and donor type and CKD. 59 (76.6%) of 77 patients whose GFR was evaluated according to cystatin C were evaluated as <90 mL/min/1.73 m2. AKI development and CMV infection and being > 10 years old at the time of transplantation were associated with decreased renal function. Decrease in renal functions according to eGFR-SCr-cysC was detected in 20 (26%) cases. Decrease in renal functions according to eGFR-SCr-cysC was detected in 20 (26%) cases. No correlation was found between the development of AKI and CMV infection, age, development of GVHD, TVI, sepsis, nephrotoxic drug intake, VOH, hemorrhagic cystitis, transplant and donor type, and decreased renal functions.