Evidence map›Paper›PMID 37260983›Full record

ArticleFrontiers in oncology2023

Acute kidney injury and chronic kidney disease in umbilical cord blood transplant recipients.

Paolo Lopedote, Elisabetta Xue, Julie Chotivatanapong, Emily C Pao, Chiara Wychera, Ann E Dahlberg, Laurel Thur, Laura Roberts, Kelsey Baker, Ted A Gooley and 2 more

Open access · goldAbstract read
In one paragraph

Article in Frontiers in oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 29% 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

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Review
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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

12 authors at 3 institutions in 2 countries.

Paolo LopedoteDepartment of Medicine, St. Elizabeth's Medical Center, Boston University, Boston, MA, United States.
Elisabetta XueHematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.
Julie ChotivatanapongClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Emily C PaoClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Chiara WycheraClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Ann E DahlbergClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Laurel ThurClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Laura RobertsClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Kelsey BakerClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Ted A GooleyClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Sangeeta HingoraniClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Filippo MilanoClinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.
Fred Hutch Cancer Center · USBoston University · USVita-Salute San Raffaele University · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Acute kidney injury (AKI) is a frequent early complication post hematopoietic stem cell transplant (HSCT), associated with high morbidity and mortality. Cord blood transplant (CBT) recipients are potentially exposed to more nephrotoxic insults, compared to patients undergoing HSCT from other donor sources. We aimed to identify risk factors for AKI in patients undergoing CBT. We also aimed to identify the impact of AKI on chronic kidney disease (CKD) and survival outcomes by one-year post-CBT. Methods: Adults and children who underwent a first CBT at our Institution were retrospectively evaluated. AKI was staged according to Kidney Disease Improving Global Outcomes (KDIGO) definitions. Cox regression models were used to estimate the association of demographic factors and post-CBT parameters with the cause-specific hazard of AKI. Results: We identified 276 patients. Median age was 32 years, 28% (77/276) were children (<18 years) and 129 (47%) were white. A myeloablative conditioning regimen was administered to 243 patients (88%) and 248 (90%) received cyclosporine for GVHD prophylaxis. One-hundred and eighty-six patients (67%) developed AKI by day 60 post-transplant, with 72 (26%) developing severe AKI (stage 2 and 3). In a multivariable analysis, each increase in bilirubin level of 1 mg/dL was associated with a 23% increase in the risk of severe AKI (adjusted HR 1.23, 95% CI 1.13 - 1.34, p<.0001). Conversely, systemic steroid administration appeared to be protective of severe AKI (unadjusted HR 0.36, 95% CI 0.18 - 0.72, p=.004) in a univariate model . Two-hundred-forty-seven patients were evaluable at the one-year time point. Among those, 100 patients (40%) developed CKD one-year post-CBT. Severe AKI was associated with a higher hazard of non-relapse mortality (adjusted HR=3.26, 95% CI 1.65-6.45, p=.001) and overall mortality (adjusted HR=2.28, 95% CI 1.22-4.27, p=.01). Discussion: AKI is a frequent complication after CBT and is associated with worse outcomes. Questions remain as to the mechanism of the protective role of steroids on kidney function in the setting of CBT.

Indexed as

acute kidney injury (AKI)allogenic stem cell transplantationbilirubinchronic kidney disease (CKD)cord blood transplantation (CBT)graft versus host disease (GVHD)steroid

Identifiers

PMID37260983
PMCPMC10229046
OpenAlexW4376891962

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Registered trials

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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.