AKI treated with kidney replacement therapy in critically Ill allogeneic hematopoietic stem cell transplant recipients

Acute kidney injury (AKI) is a frequent complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), but few studies have focused on AKI treated with kidney replacement therapy (AKI-KRT), particularly among critically ill patients. We investigated the incidence, risk factor...

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Bibliographic Details
Published in:Bone marrow transplantation (Basingstoke) 2024-02, Vol.59 (2), p.178-188
Main Authors: Kim, Helena, Ali, Rafia, Short, Samuel, Kaunfer, Sarah, Krishnamurthy, Shobana, Durai, Lavanya, Yilmam, Osman, Shenoy, Tushar, Monson, Audrey E., Thomas, Charlotte, Park, Isabel, Martini, Dylan, Newcomb, Richard, Shapiro, Roman M., Soiffer, Robert J., DeFilipp, Zachariah, Baron, Rebecca M., Gupta, Shruti, Sise, Meghan E., Leaf, David E.
Format: Article
Language:English
Subjects:
631/250/1904
631/532/1542
692/308/174
692/499
Acute Kidney Injury - etiology
Acute Kidney Injury - therapy
Adult
Allografts
Bilirubin
Cell Biology
Critical Illness - therapy
Health care facilities
Hematology
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic stem cells
Humans
Hypoxemia
Internal Medicine
Kidney transplantation
Kidneys
Mechanical ventilation
Medicine
Medicine & Public Health
Mortality
Public Health
Renal replacement therapy
Renal Replacement Therapy - adverse effects
Retrospective Studies
Risk factors
Serum albumin
Stem cell transplantation
Stem Cells
Subgroups
Thrombotic microangiopathy
Transplants & implants
Veno-occlusive disease
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Summary:Acute kidney injury (AKI) is a frequent complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), but few studies have focused on AKI treated with kidney replacement therapy (AKI-KRT), particularly among critically ill patients. We investigated the incidence, risk factors, and 90-day mortality associated with AKI-KRT in 529 critically ill adult allo-HSCT recipients admitted to the ICU within 1-year post-transplant at two academic medical centers between 2011 and 2021. AKI-KRT occurred in 111 of the 529 patients (21.0%). Lower baseline eGFR, veno-occlusive disease, thrombotic microangiopathy, admission to an ICU within 90 days post-transplant, and receipt of invasive mechanical ventilation (IMV), total bilirubin ≥5.0 mg/dl, and arterial pH
ISSN:0268-3369
1476-5365
DOI:10.1038/s41409-023-02136-8