Evidence map›Paper›PMID 36125547›Full record

ArticlePediatric nephrology (Berlin, Germany)2023

Risk factors for severe acute kidney injury after pediatric hematopoietic cell transplantation.

Abbie Bauer, Kristen Carlin, Stephen M Schwartz, Meera Srikanthan, Monica Thakar, Lauri M Burroughs, Jodi Smith, Sangeeta Hingorani, Shina Menon

Abstract read
PubMed Publisher
In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Abbie BauerDivision of Nephrology, Department of Pediatrics, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97238, USA. baueab@ohsu.edu.ORCID 0000-0002-4215-2606
Kristen CarlinChildren's Core for Biomedical Statistics, Seattle Children's Research Institute, Seattle, USA.
Stephen M SchwartzDepartment of Epidemiology, School of Public Health, University of Washington, Seattle, USA.
Meera SrikanthanDivision of Hematology Oncology, Department of Pediatrics, University of Minnesota, Minneapolis, USA.
Monica ThakarDivision of Hematology Oncology, Department of Pediatrics, Fred Hutchinson Cancer Center, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, USA.
Lauri M BurroughsDivision of Hematology Oncology, Department of Pediatrics, Fred Hutchinson Cancer Center, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, USA.
Jodi SmithDivision of Nephrology, Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, USA.
Sangeeta HingoraniDivision of Nephrology, Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, USA.
Shina MenonDivision of Nephrology, Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, USA.
Seattle Children's Hospital · USCape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South Africa · ZAOregon Health & Science University · USSeattle University · USUniversity of Minnesota · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute kidney injury (AKI) is common after hematopoietic cell transplantation (HCT) and is associated with poorer outcomes. Risk factors for AKI after pediatric HCT are not fully understood. The study objective was to assess unique risk factors for AKI in the HCT population and evaluate post-HCT AKI patterns.

methodsWe conducted a retrospective cohort study of patients < 21 years of age who underwent HCT at Seattle Children's Hospital/Fred Hutchinson Cancer Center from September 2008 to July 2017 (n = 484). We defined AKI using KDIGO criteria. We collected demographics, baseline HCT characteristics, post-HCT complications, and mortality. Multinomial logistic regression was used to estimate association between AKI and potential risk factors. We used adjusted Cox proportional hazard ratios to evaluate differences in mortality.

resultsOne hundred and eighty-six patients (38%) developed AKI. Seventy-nine (42%) had severe AKI and 27 (15%) required kidney replacement therapy. Fluid overload was common in all groups and 67% of those with severe AKI had > 10% fluid overload. Nephrology was consulted in less than 50% of those with severe AKI. In multivariable analysis, risk of severe AKI was lower in those taking a calcineurin inhibitor (CNI). Risk of death was higher in severe AKI compared to no AKI (RR 4.6, 95% CI 2.6-8.1).

conclusionsAKI and fluid overload are common in pediatric patients after HCT. Severe AKI occurred less often with CNI use and was associated with higher mortality. Future interventions to reduce AKI and its associated complications such as fluid overload are approaches to reducing morbidity and mortality after HCT. A higher resolution version of the Graphical abstract is available as Supplementary information.

Indexed as

Acute Kidney InjuryHematopoietic Stem Cell TransplantationChildHumansRenal Replacement TherapyRetrospective StudiesRisk FactorsAcute kidney injuryCalcineurin inhibitorsFluid overloadHematopoietic cell transplantationPediatricsRisk factors

Identifiers

PMID36125547
OpenAlexW4297855437

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.