Bone marrow transplantation (BMT) is a major treatment for malignant and hematologic disorders. This procedure is associated with a high morbidity and mortality such as acute kidney injury (AKI).Many factors, such as therapeutic agents, irradiation and graft versus host disease (GVHD) can cause AKI. Bone marrow transplantation conditioning therapy in Iran is based on drugs, such as busulfan and cyclophosphamide and without radiation therapy. The aim of this study was to evaluate the frequency, risk factors and mortality of AKI among patients who underwent BMT. To evaluate the frequency of AKI and its outcome, 375 patients were followed prospectively for 180 days from time of transplant. Acute kidney injury was defined as doubling serum creatinine from baseline at any time during the first 180 days post-transplant. The risk of AKI in relation to non based total body irradiation conditioning regimen ,type of graft (allograft, autograft) and comorbidity , graft versus host disease(GVHD), drug toxicity and veno- occlusive disease(VOD) was examined in 375 BMT patients. One hundred twenty –two patients (37.6%) developed AKI at a median of 18 days after transplant . Higher frequency was observed in patients who received cyclosporine A (40%) and in allograft BMT those patients with gastrointestinal graft versus host disease (GIGVHD) (47.3%).The remainder was for amphotericine B, veno- occlusive disease (VOD), hemolytic uremic syndrome (HUS). In conclusion, the frequency of AKI remains high. Cyclosporine A and amphotericine B and presence of GVHD and VOD increased the risk of ARF within the first 180 days after BMT.
Volume : 6
Issue : 4
Pages : 122
Shariati Hospital, Tehran University of Medical Sciences, Tehran , Iran.