Frequency, Risk Factors, and Outcome of Acute Kidney Injury Following Bone Marrow Transplantation at Dr Shariati Hospital in Tehran

Introduction. Bone marrow transplantation (BMT) is a majormodality for malignant and hematologic disorders. This procedureis associated with a high morbidity and mortality such as acutekidney injury (AKI). Many factors, such as therapeutic agents,irradiation, and graft versus host disease (GVHD) can cause AKI.Bone marrow transplantation conditioning therapy in Iran is basedon drugs such as busulfan and cyclophosphamide and withoutirradiation therapy. The aim of this study was to evaluate thefrequency, risk factors, and mortality of AKI among patients whounderwent BMT.Materials and Methods. Acute kidney injury was defined asdoubling serum creatinine from baseline at any time during thefirst 180 days posttransplant. The risk of AKI in relation to nontotal-body-irradiation-based conditioning regimen, type of graft(allograft and autograft), comorbidities, GVHD, drug toxicity, andveno-occlusive disease were examined in 375 patients with BMT.Results. One hundred and forty-two patients (37.6%) developedAKI at a median of 18 days after transplant. A higher frequency ofAKI was observed in patients who received cyclosporine A (40%),patients with allograft BMT (42.1%), and those who developedgastrointestinal GVHD (47.3%) .The remainder AKI cases wereassociated with amphotericin B, veno-occlusive disease, andhemolytic-uremic syndrome.Conclusions. The frequency of AKI in our patients with BMTremained high. Cyclosporine A and amphotericin B and thepresence of GVHD and veno-occlusive disease increased the riskof AKI within the first 180 days after BMT.