Markova Petya, Yaneva Antoniya, Markov Stoyan, Spasova Mariya, Spasov Neofit
Department of Pediatrics, Medical Faculty, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.
Department of Pediatrics, University Hospital "St. George", 4000 Plovdiv, Bulgaria.
Children (Basel). 2025 Apr 23;12(5):540. doi: 10.3390/children12050540.
Progress in the treatment of childhood oncological diseases has led to the prolonged survival of patients with this severe diagnosis. On the other hand, the prolonged chemotherapy courses that achieve this outcome also bring a number of complications, with acute kidney injury being one of them. Its occurrence in patients not only affects their quality of life but also prolongs and increases the cost of hospitalization, burdens the body with additional treatment, and impacts the ability to manage the underlying disease. The aim of this study is to determine the frequency of acute kidney injury among children hospitalized in the Pediatric Oncohematology Unit in Plovdiv during the period 2016-2020, as well as to identify the risk factors for its occurrence, its severity, and its dependence on tumor type, gender, and age. During the five-year period under review, a total of 213 newly diagnosed children with hematological diseases were admitted to our Pediatric Oncohematology Unit-122 boys and 91 girls. Acute kidney injury was identified in 94 (44.1%) of the children-54 with solid tumors and 40 with malignant hemopathies. The main cause of acute kidney injury diagnosed was drug-induced nephrotoxicity, especially due to nephrotoxic chemotherapeutic agents. No statistically significant association was found between the type of tumor and the occurrence of acute kidney injury. Of the children with documented episodes of AKI, 11 were found to have CKD according to the KDIGO criteria. Acute kidney injury is a common complication that occurs during the medical treatment of children with malignant diseases.
儿童肿瘤疾病治疗方面的进展使得患有这种严重疾病的患者生存期延长。另一方面，为实现这一结果而进行的长期化疗疗程也带来了一些并发症，急性肾损伤就是其中之一。它在患者中的发生不仅影响其生活质量，还延长并增加了住院费用，使身体承受额外治疗的负担，并影响对基础疾病的管理能力。本研究的目的是确定2016年至2020年期间在普罗夫迪夫儿科肿瘤血液科住院的儿童中急性肾损伤的发生率，以及确定其发生的风险因素、严重程度及其与肿瘤类型、性别和年龄的相关性。在审查的五年期间，共有213名新诊断的血液疾病儿童入住我们的儿科肿瘤血液科——122名男孩和91名女孩。94名（44.1%）儿童被诊断为急性肾损伤——54名患有实体瘤，40名患有恶性血液病。诊断出的急性肾损伤的主要原因是药物性肾毒性，尤其是由于肾毒性化疗药物。未发现肿瘤类型与急性肾损伤的发生之间存在统计学上的显著关联。在有急性肾损伤记录的儿童中，根据KDIGO标准，有11名被发现患有慢性肾脏病。急性肾损伤是儿童恶性疾病医疗过程中常见的并发症。
