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Abstract: TH-PO521

Epidemiology and Outcomes of AKI and Dialysis After Bone Marrow Transplant in Pediatric Patients

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

Authors

  • Ashruf, Omer S., Northeast Ohio Medical University, Rootstown, Ohio, United States
  • Orozco, Zara C., Northeast Ohio Medical University, Rootstown, Ohio, United States
  • Haq, Imad U., Northeast Ohio Medical University, Rootstown, Ohio, United States
  • Ashruf, Zaid, Northeast Ohio Medical University, Rootstown, Ohio, United States
  • Sethi, Sidharth Kumar, Medanta The Medicity Medanta Institute of Kidney and Urology, Gurugram, Haryana, India
  • Raina, Rupesh, Cleveland Clinic Akron General, Akron, Ohio, United States
Background

Acute kidney injury (AKI) is a common post-operative complication of bone marrow transplantation (BMT) in pediatric patients, with high mortality and morbidity. However, little is known about the epidemiologic characteristics. We assessed the characteristics, risk factors, and outcomes of BMT-induced AKI and the incidence, prevalence, and mortality of dialysis in the pediatric population.

Methods

Using patient data from TriNetX, a platform of health record data from 101 healthcare organizations, two cohorts were identified using ICD-10/lab/procedure/prescription codes: <18y/o patients with AKI within 30 days of BMT, and <18y/o patients who underwent BMT excluding AKI. Cohorts were 1:1 propensity matched for age, sex, and race. Outcomes assessed were: characteristics, risk factors, and clinical outcomes (hospitalization, emergency department [ED] visit, intensive care unit [ICU] admit, and mortality) after 6 and 12 months and incidence, prevalence, and mortality of dialysis patients post-AKI. Risk ratio (RR) and hazard ratio (HR) with 95% confidence intervals (95% Cl) and Kaplan-Meier analysis were conducted.

Results

After matching, 524 pediatric patients were included. Characteristics, risk factors, and outcomes are in Table 1. Patients with AKI had higher rates of all clinical outcomes and greater mortality risk: 12.8% reduction in survival probability at 6 months and 14.6% at 1 year, Figure 1. The incidence of dialysis post-BMT and AKI was 4.3% at 1 year and 10.6% at 5 years, while the prevalence was 12.8% at 1 year and 14.6% at 5 years. Survival probability was 11.9% below the control cohort.

Conclusion

We found BMT-induced AKI and dialysis led to worse clinical outcomes in child patients. Further research is needed to develop preventive/management strategies for this high-risk population.

Funding

  • Other NIH Support