Assessing long-term renal outcome after allogeneic hematopoietic stem
cell transplantation in children with estimated glomerular filtration
rate equations, based on creatinine and cystatin C levels.
Abstract
Background: With the widespread use of hematopoietic stem cell
transplantation (HSCT), long-term complications have come to the fore.
The aim of this study is to determine the prevalence and risk factors of
chronic kidney disease (CKD) developing in the long term in patients who
underwent allogeneic HSCT in childhood and also to investigate the
superiority of eGFR formulas. Methods: The present study evaluated CKD
in patients undergoing allogeneic HSCT. We analyzed the 94 children who
received allogeneic HSCT at the Ege University in İzmir between 2019
August and 2019 November. The patients were evaluated at least 2 years
after transplantation. CKD was defined as a glomerular filtration rate
(GFR)<90 mL/min/1.73 m2, using eGFR equations which are based
on serum creatinine (SCr), cystatin C (CysC), and SCr plus CysC.
Results: In our study, 9 (9.4%) according to Bedside Schwartz, 59
(76.6%) according to CKiD-eGFR-CysC and 20 (26%) patients according to
CKiD-eGFR-SCr-CysC equation were evaluated as CKD. In cases evaluated as
CKD according to CysC, early development of acute kidney injury (AKI),
posttransplant cytomegalovirus (CMV) reactivation and being
>10 years old during transplantation were found to be
associated with the development of CKD. Conclusion: We may be delayed in
detecting CKD by calculating SCr-based formulas in HSCT cases, which is
a patient group where early diagnosis and treatment of CKD is very
important.