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Meta-Analysis
. 2020 Sep 1;113(9):621-632.
doi: 10.1093/qjmed/hcaa072.

Incidence and mortality of acute kidney injury in patients undergoing hematopoietic stem cell transplantation: a systematic review and meta-analysis

S R Kanduri  1 , W Cheungpasitporn  1 , C Thongprayoon  2 , T Bathini  3 , K Kovvuru  1 , V Garla  4 , J Medaura  1 , P Vaitla  1 , K B Kashani  2   5
Affiliations
Meta-Analysis

Incidence and mortality of acute kidney injury in patients undergoing hematopoietic stem cell transplantation: a systematic review and meta-analysis

S R Kanduri et al. QJM. .

Abstract

Background: While acute kidney injury (AKI) is commonly reported following hematopoietic stem cell transplant (HCT), the incidence and impact of AKI on mortality among patients undergoing HCT are not well described. We conducted this systematic review to assess the incidence and impact of AKI on mortality risk among patients undergoing HCT.

Methods: Ovid MEDLINE, EMBASE and the Cochrane Databases were searched from database inceptions through August 2019 to identify studies assessing the incidence of AKI and mortality risk among adult patients who developed AKI following HCT. Random-effects and generic inverse variance method of DerSimonian-Laird were used to combine the effect estimates obtained from individual studies.

Results: We included 36 cohort studies with a total of 5144 patients undergoing HCT. Overall, the pooled estimated incidence of AKI and severe AKI (AKI Stage III) were 55.1% (95% confidence interval (CI) 46.6-63.3%) and 8.3% (95% CI 6.0-11.4%), respectively. The pooled estimated incidence of AKI using contemporary AKI definitions (RIFLE, AKIN and KDIGO criteria) was 49.8% (95% CI 41.6-58.1%). There was no significant correlation between study year and the incidence of AKI (P = 0.12) or severe AKI (P = 0.97). The pooled odds ratios of 3-month mortality and 3-year mortality among patients undergoing HCT with AKI were 3.05 (95% CI 2.07-4.49) and 2.23 (95% CI 1.06-4.73), respectively.

Conclusion: The incidence of AKI among patients who undergo HCT remains high, and it has not changed over the years despite advances in medicine. AKI after HCT is associated with increased short- and long-term mortality.

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Figures

Figure 1.
Figure 1.
Outlines the flowchart of paper selection for inclusion.
Figure 2.
Figure 2.
Forest plots of the included studies evaluating incidence rates of AKI among patients undergoing HCT.
Figure 3.
Figure 3.
Forest plots of the included studies evaluating incidence rates of severe AKI among patients undergoing HCT.
Figure 4.
Figure 4.
Forest plots of the included studies evaluating (A) mortality risk of AKI within 3 months and (B) mortality risk of AKI within 3 years after HCT.
See this image and copyright information in PMC

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References

    1. Kogon A, Hingorani S.. Acute kidney injury in hematopoietic cell transplantation. Semin Nephrol 2010; 30:615–26. - PMC - PubMed
    1. Burt RK, Traynor A, Statkute L, Barr WG, Rosa R, Schroeder J, et al.Nonmyeloablative hematopoietic stem cell transplantation for systemic lupus erythematosus. JAMA 2006; 295:527–35. - PubMed
    1. Burt RK, Verda L, Statkute L, Quigley K, Yaung K, Brush M, et al.Stem cell transplantation for autoimmune diseases. Clin Adv Hematol Oncol 2004; 2:313–9. - PubMed
    1. Oyama Y, Craig RM, Traynor AE, Quigley K, Statkute L, Halverson A, et al.Autologous hematopoietic stem cell transplantation in patients with refractory Crohn’s disease. Gastroenterology 2005; 128:552–63. - PubMed
    1. Parikh CR, Coca SG.. Acute renal failure in hematopoietic cell transplantation. Kidney Int 2006; 69:430–5. - PubMed