Acute kidney injury in pediatric hematopoietic cell transplantation: critical appraisal and consensus

Rupesh Raina; Rolla Abu-Arja; Sidharth Sethi; Richa Dua; Ronith Chakraborty; James T Dibb; Rajit K Basu; John Bissler; Melvin Bonilla Felix; Patrick Brophy; Timothy Bunchman; Khalid Alhasan; Dieter Haffner; Yap Hui Kim; Christopher Licht; Mignon McCulloch; Shina Menon; Ali Mirza Onder; Prajit Khooblall; Amrit Khooblall; Veronika Polishchuk; Hemalatha Rangarajan; Azmeri Sultana; Clifford Kashtan

doi:10.1007/s00467-022-05448-x

Acute kidney injury in pediatric hematopoietic cell transplantation: critical appraisal and consensus

Pediatr Nephrol. 2022 Jun;37(6):1179-1203. doi: 10.1007/s00467-022-05448-x. Epub 2022 Feb 28.

Authors

Rupesh Raina^{1

2}, Rolla Abu-Arja^{3

4}, Sidharth Sethi⁵, Richa Dua⁶, Ronith Chakraborty⁷, James T Dibb⁸, Rajit K Basu⁹, John Bissler¹⁰, Melvin Bonilla Felix¹¹, Patrick Brophy¹², Timothy Bunchman¹³, Khalid Alhasan¹⁴, Dieter Haffner¹⁵, Yap Hui Kim^{16

17}, Christopher Licht¹⁸, Mignon McCulloch¹⁹, Shina Menon²⁰, Ali Mirza Onder^{21

22}, Prajit Khooblall²³, Amrit Khooblall⁷, Veronika Polishchuk^{3

4}, Hemalatha Rangarajan^{3

4}, Azmeri Sultana²⁴, Clifford Kashtan²⁵

Affiliations

¹ Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA. rraina@akronchildrens.org.
² Department of Nephrology, Akron Children's Hospital, Akron, OH, USA. rraina@akronchildrens.org.
³ Division of Hematology, Oncology, Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA.
⁴ Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
⁵ Pediatric Nephrology, Kidney Institute, Medanta, The Medicity Hospital, Gurgaon, Haryana, India.
⁶ Monmouth Medical Center, Long Branch, NJ, USA.
⁷ Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA.
⁸ Department of Internal Medicine, Summa Health System - Akron Campus, Akron, OH, USA.
⁹ Children's Healthcare of Atlanta, Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
¹⁰ Department of Pediatrics, University of Tennessee Health Science Center and Le Bonheur Children's Hospital, Memphis, TN, USA.
¹¹ Department of Pediatrics, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
¹² Department of Pediatrics, University of Rochester School of Medicine, Rochester, NY, USA.
¹³ Pediatric Nephrology & Transplantation, Children's Hospital of Richmond at VCU, Richmond, VA, USA.
¹⁴ Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
¹⁵ Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
¹⁶ Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
¹⁷ Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore.
¹⁸ Division of Nephrology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
¹⁹ Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
²⁰ Division of Pediatric Nephrology, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA.
²¹ Division of Pediatric Nephrology, Le Bonheur Children's Hospital, University of Tennessee, School of Medicine, Memphis, TN, USA.
²² Division of Pediatric Nephrology, Batson Children's Hospital of Mississippi, University of Mississippi Medical Center, Jackson, MS, USA.
²³ Department of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.
²⁴ Department of Pediatric Nephrology, MR Khan Hospital & Institute of Child Health, Mirpur-2, Dhaka, Bangladesh.
²⁵ Department of Pediatrics, Division of Pediatric Nephrology, University of Minnesota Medical School, Minneapolis, MN, USA.

PMID: 35224659
DOI: 10.1007/s00467-022-05448-x

Abstract

Hematopoietic cell transplantation (HCT) is a common therapy for the treatment of neoplastic and metabolic disorders, hematological diseases, and fatal immunological deficiencies. HCT can be subcategorized as autologous or allogeneic, with each modality being associated with their own benefits, risks, and post-transplant complications. One of the most common complications includes acute kidney injury (AKI). However, diagnosing HCT patients with AKI early on remains quite difficult. Therefore, this evidence-based guideline, compiled by the Pediatric Continuous Renal Replacement Therapy (PCRRT) working group, presents the various factors that contribute to AKI and recommendations regarding optimization of therapy with minimal complications in HCT patients.

Keywords: Acute kidney injury; Bone marrow transplant; Hematopoietic cell transplantation; KRT; Pediatrics; Transplant.

Publication types

Review

MeSH terms

Acute Kidney Injury* / diagnosis
Acute Kidney Injury* / etiology
Acute Kidney Injury* / therapy
Child
Consensus
Hematopoietic Stem Cell Transplantation* / adverse effects
Humans
Transplantation, Autologous / adverse effects