عنوان

Evaluating the Frequency of Acute Kidney Injury in Patients with Fanconi Anemia after Hematopoietic Stem Cell Transplantation at Children’s Medical Center Between September 2016 and September 2021,ارزیابی فراوانی آسیب حاد کلیه در بیماران مبتلا به کم خونی فانکونی بعد از پیوند سلول های بنیادی خون ساز در مرکز طبی کودکان بین سپتامبر 2016 و سپتامبر 2021

Number

98967P

.Language of Text, Soundtrack etc

انگلیسی

Title Proper

Evaluating the Frequency of Acute Kidney Injury in Patients with Fanconi Anemia after Hematopoietic Stem Cell Transplantation at Children’s Medical Center Between September 2016 and September 2021

Title Proper

ارزیابی فراوانی آسیب حاد کلیه در بیماران مبتلا به کم خونی فانکونی بعد از پیوند سلول های بنیادی خون ساز در مرکز طبی کودکان بین سپتامبر 2016 و سپتامبر 2021

General Material Designation

[Dissertation]

First Statement of Responsibility

Nyasha Sandaramu

First Statement of Responsibility

نیاشا ساندارامو

Name of Publisher, Distributor, etc.

Tehran University of Medical Sciences, Medicine school

Date of Publication, Distribution, etc.

2023

Specific Material Designation and Extent of Item

77p

Dissertation or thesis details and type of degree

Doctor Of Medicine(MD)

Date of degree

1401/12/15

Text preceding or following the note

18

Text of Note

Objective: Is to evaluate the prevalence of Acute Kidney Injury (AKI) in patients with Fanconi Anemia (FA) after Hematopoietic Stem Cell Transplantation (HSCT) at Children’s Medical Center Between September 2016 and September 2021.Method: We retrospectively investigated 30 FA patients who had complete medical records who underwent HSCT between 2016 and 2021. We investigated the incidence and risk factors of AKI within 30 days after post-HSCT in FA patients. Clinical medical records and renal imaging was also reviewed to check for Congenital Anomalies of Kidney Urinary Tract (CAKUT). Result: In our study the incidence of AKI was 26.7% (mainly stage 1 and stage 2). Patients aged ≥ 11 years at transplantation showed a higher risk of AKI (OR 7.5) (P value = 0.019). Pre-HSCT median and mean eGFR on the day before HSCT for all patients was 85ml/min/1.73m2 (range:58–130), and 87.33ml/min/1.73m2. Median eGFR on the day before HSCT in patients with and without CAKUT was 78 ml/min/1.73m2 (range:58–97) and 89ml/min/1.73m2 (range: 60–130), respectively. The median eGFR post-HSCT on the day the highest serum Cr was recorded (on the day AKI was suspected) in patients with and without CAKUT was 65ml/min/1.73m2 (range: 31– 85) and 70ml/min/1.73m2 (range: 38– 93), respectively. Out of 8 patients ,2 patients had CAKUT and their eGFR on the day they had AKI was below 45ml/min/1.73m2 (31 and 41) showing stage G3B moderate to severely decreased (CKD stage 3B). The incidence of acute Graft-Versus-Host-Disease (aGVHD) in patients who had CAKUT was 3 (33.3%) of them didn’t have acute GVHD, 5 (55.6%) of them had acute GVHD grade I-II and 1 (11.1%) had acute GVHD grade III-IV and for those patients who didn’t have CAKUT, 10 (47.6%) had no aGVHD, 2 (9.5%) had aGVHD grade I-II and 9 (42.9%) had aGVHD grade III-IV. The chi-square test was done and the (P-value=0.019). Conclusion: Based on the results of this study, the frequency of AKI was more in patients without renal anomalies as than in patients with renal anomalies with an incidence rate of 26.7% and (P value=0.719) (OR 0.714). But Patients aged ≥ 11 years at transplantation showed a higher risk of AKI (OR 7.5) and patient’s age at transplantation age is associated with the risk of developing AKI post HSCT. There is also a significant association between renal anomalies and aGVHD. Since hematopoietic stem cell transplantation at a younger age is associated with fewer kidney complications, it is recommended that the patient be referred for hematopoietic stem cell transplantation as soon as possible after diagnosis.

Fanconi Anemia

آسیب حاد کلیه

کم خونی

سلولهای بنیادی

Kidney Injury

CAKUT

AKI

HSCT

renal anomalies

CKD

aGVHD

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, Author

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, Author

Sandaramu, Nyasha

ساندارامو، نیاشا

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, Thesis advisor

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, Thesis advisor

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, Thesis advisor

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, Thesis advisor

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, Consulting advisor

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, Consulting advisor

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, Consulting advisor

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, Consulting advisor

Askarian, Fahimeh

عسکریان، فهیمه

Behfar, Maryam

بهفر، مریم

Hamidieh, Amirali

حمیدیه، امیرعلی

Bazargani, Behnaz

بازرگانی، بهناز

Moghtaderi, Mastaneh

مقتدری، مستانه

Abbasi, Arash

عباسی، آرش

Entry Element

Tehran University of Medical Sciences, Medicine school

Country

ایران

Date of Transaction

20230314

Call Number

26039P

Electronic name

p

TL

276903

a

Y