Tanase Alina, Andronesi Andreea, Sorohan Bogdan, Vasile Andreea, Lipan Lavinia, Varady Zsofia, Stefan Laura, Craciun Oana, Ranete Adela, Obrisca Bogdan, Cioata Rebeca, Ismail Gener
Bone Marrow Transplant Department, Fundeni Clinical Institute, Bucharest, Romania.
Nephrology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Ren Fail. 2025 Dec;47(1):2535517. doi: 10.1080/0886022X.2025.2535517. Epub 2025 Aug 4.
Chronic kidney disease (CKD) in hematopoietic stem cell transplantation (HSCT) is becoming more common. Only few studies were published during the past 10 years. Identification of risk factors is of outmost importance.
We assessed prospectively a cohort of 197 patients who underwent allogeneic HSCT, aiming to evaluate the incidence and risk factors associated with CKD. We registered the persistence of the low GFR. Cox proportional hazard analysis has been used to identify the risk factors.
The mean age was 38.7 years (52.8% female). Acute kidney injury was present in 80% patients within 3 months and CKD incidence was 11.7% with a median onset of 6 months. By univariate Cox regression analysis, age (per 1 year) was the only variable associated with CKD (HR= 1.06, 95%, CI= 1.02-1.10, = 0.001) and baseline creatinine (per 1 mg/dl) presented a trend of association (HR= 4.62, 95%, CI= 0.75-28.42, = 0.09). Multivariate Cox regression analysis showed that age (per 1 year; HR= 1.08, 95%, CI = 1.02-1.14, = 0.003) and hematologic disease length (per 1 month; HR = 1.01, 95%, CI= 1.001-1.02, = 0.02) were positive predictors for CKD, whereas acute lymphoblastic leukemia (HR= 0.37, 95%, CI= 0.20-0.61, = 0.02) was a negative predictor factor, being associated with a 63% reduction risk for developing CKD.
As the prognostic of hematopoietic stem cell transplantation survivors is improving, CKD emerges as an important comorbidity, with hematologic disease length and baseline eGFR being independent risk factors for renal dysfunction.
造血干细胞移植（HSCT）中的慢性肾脏病（CKD）正变得越来越常见。在过去10年中仅有少数研究发表。识别危险因素至关重要。
我们前瞻性评估了197例接受异基因HSCT的患者队列，旨在评估CKD的发生率及相关危险因素。我们记录了低肾小球滤过率（GFR）的持续情况。采用Cox比例风险分析来识别危险因素。
平均年龄为38.7岁（52.8%为女性）。80%的患者在3个月内出现急性肾损伤，CKD发生率为11.7%，中位发病时间为6个月。单因素Cox回归分析显示，年龄（每增加1岁）是与CKD相关的唯一变量（风险比[HR]=1.06，95%置信区间[CI]=1.02 - 1.10，P = 0.001），且基线肌酐（每增加1mg/dl）呈现出关联趋势（HR = 4.62，95% CI = 0.75 - 28.42，P = 0.09）。多因素Cox回归分析表明，年龄（每增加1岁；HR = 1.08，95% CI = 1.02 - 1.14，P = 0.003）和血液系统疾病病程（每增加1个月；HR = 1.01，95% CI = 1.001 - 1.02，P = 0.02）是CKD的阳性预测因素，而急性淋巴细胞白血病（HR = 0.37，95% CI = 0.20 - 0.61，P = 0.02）是阴性预测因素，与发生CKD的风险降低63%相关。
随着造血干细胞移植幸存者的预后不断改善，CKD成为一种重要的合并症，血液系统疾病病程和基线估算肾小球滤过率（eGFR）是肾功能不全的独立危险因素。
