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Abstract: PO1904

Changes in Humoral Biomarkers (Klotho) in Patients with Haematological Tumors Undergoing Chemotherapy and Allogeneic Bone Marrow Transplantation Developing AKI

Session Information

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Fontana, Simone, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Lanzani, Chiara, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Messaggio, Elisabetta, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Manunta, Paolo, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Group or Team Name

  • UO nefrologia San Raffaele, UO ematologia San Raffaele
Background

Acute kidney injury (AKI) is a complication in patients with hematological cancers after chemotherapy (CT) receiving allogeneic bone marrow transplant. It increases the morbidity and mortality rate associated with the procedure. Some urinary/plasma biomarkers (Klotho) have been evaluated as predictors of AKI development after cardiac surgery showing high prognostic value

Methods

Our work is investigating the role and association of these determinants as early markers of susceptibility to AKI during CT, and predictors of CKD. So far, we have enrolled 13 leukemic patients who are candidates for induction CT and subsequent bone marrow transplantation. All the patients carried out sampling for renal function at each cycle and at the same time plasma and urine were collected. Klotho plasma levels were measured in 4 phases diagnosis (t1); onset of AKI/2 months from diagnosis in patients without damage (t2); 15 days after t2 (t3); bone marrow tx (t4)

Results

We measured Klotho levels in 13 patients. The subjects are respectively 9 M and 4 F, mean age 49 years, all with normal renal function (mean creatinine 0.81 mg/dl) at diagnosis. The mean number of chemotherapy courses was 3.2. 7 patients developed stage I AKI according to AKIN criteria. No differences in anthropometric parameters were observed between the two groups. In subjects with development of renal damage, the average time of development was 2 months from diagnosis. While plasma Kl decreases in a similar way in the first CT in the two groups, in no-AKI group the filtrate return normal before the next cycle. The restoration of normal kidney function is not observed in the Aki group (MANOVA p <0.006)

Conclusion

This trend allows us to hypothesize that Kl is an indication of incomplete recovery of renal (tubular?) function before the next CT cycle, predisposing to the development of kidney disease

Funding

  • Private Foundation Support