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Abstract: TH-PO520

Incidence of Nephromegaly Following Hematopoietic Stem Cell Transplantation in Children and Young Adults

Session Information

  • Pediatric Nephrology - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Author

  • Bou Matar, Raed, Cleveland Clinic, Cleveland, Ohio, United States
Background

Hematopoietic stem cell transplantation (HSCT) is an effective treatment for a variety of malignancies, metabolic and autoimmune diseases. Complications of HSCT include infections, veno-occlusive disease, mucositis, hemorrhagic cystitis, and graft-versus-host disease. Nephromegaly, along with other abdominal organomegaly, has been reported in the literature but the incidence and clinical significance is unknown.

Methods

Children and young adults (age ≤ 19 years) who underwent HSCT over a 10-year period (2011 to 2021) were screened for the study. Patients were included if they underwent a kidney ultrasound pre-HSCT and within 3 months post-HSCT. We retrospectively collected data that included demographics, type of HSCT, conditioning regimen and primary diagnosis. Data extracted from ultrasound reports included kidney length, presence, and severity of hydronephrosis and other renal anomalies. Other data points collected included HSCT source, conditioning regimen, and concurrent renal anomalies. The primary outcome of the study was the kidney length percentile for patient's age as measured by ultrasound before and within 3 months after the HSCT. Paired t-test was used for comparison of continuous data and Chi-Square test for comparing proportions.

Results

Twenty-seven patients met the inclusion criteria for the study. Median age was 7 years (20 months to 19 years) with 41% females. The kidney length percentile was significantly increased post-HSCT (79.3, IQR 71.5 - 98.7) as compared to pre-HSCT (72.4, IQR 44.9 - 97.2, p = 0.03). The percentage of patients with unilateral nephromegaly was 51.8% pre and 59.3% post HSCT (p = 0.58). The percentage of patients with bilateral nephromegaly was 14.8% pre and 29.6% post-HSCT (p = 0.19). No statistically significant differences were detected when groups were stratified by age, sex, primary diagnosis, HSCT source, conditioning regimen, and presence of other renal anomalies.

Conclusion

In this cohort of children and young adults, kidney length percentiles for age significantly increased post-HSCT. The mechanism and clinical significance of this increase requires further investigation.