Incidence of acute kidney injury in bone marrow transplant patients; investigation of consequences within one to three years

Abstract

Introduction: Previous studies have demonstrated that acute kidney injury (AKI) is a serious complication following hematopoietic stem cell transplantation (HSCT). The incidence of AKI in association with HSCT varies considerably because of several definitions for AKI. Objectives: In this study, we determined the rate of AKI after bone marrow transplantation (BMT) and its effects on patients’ outcomes according to modern definitions of AKI to conclude whether all these criteria can be useful for predicting AKI occurrence after BMT or not. Patients and Methods: We conducted a retrospective study of 271 patients undergoing HSCT, and after obtaining written informed consent from all patients, the required information was reviewed. AKI was defined according to RIFLE, KDIGO, and AKIN criteria. Renal function was assessed by calculating creatinine clearance, urine output, and estimated glomerular filtration rate (eGFR), determined through the MDRD equation. Results: Allogeneic and autologous transplantations were performed on 38 (14.02%) and 233 (85.97%) patients, respectively. According to the RIFLE criteria, 96 patients (35.42%) suffered from AKI, and based on AKIN, and KDIGO criteria, 101 patients (37.26%) were afflicted with it after BMT. The one-year mortality rate in allogeneic transplant patients with a history of AKI was 30.43% and 53.33% in patients without a history of AKI. The three-year mortality rate in allogeneic transplant patients with and without a history of AKI was 52.17% and 73.33% respectively, which showed no statistically significant difference. The three-year mortality rate in autologous transplant patients with and without a history of AKI was 60.27% and 22.5%, respectively. Conclusion: The one-year and three-year mortality rates, survival of patients, and AKI’s diagnosis were similar in all three criteria. Therefore, all these criteria can be useful for the prediction of AKI occurrence after BMT.