Supplementary Material for: Risk Factors for Acute Kidney Injury and Chronic Kidney Disease following Allogeneic Hematopoietic Stem Cell Transplantation for Hematopoietic Malignancies

<b><i>Background:</i></b> Acute kidney injury (AKI) and chronic kidney disease (CKD) are considered common complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). <b><i>Objectives and Method:</i></b> In this study, 114 patients who had undergone allo-HSCT were retrospectively analyzed to investigate the risk factors for onset of posttransplant AKI and CKD as defined by the new Kidney Disease Improving Global Outcomes criteria. <b><i>Results:</i></b> Seventy-four patients (64.9%) developed AKI and 25 (21.9%) developed CKD. The multivariate analysis showed that the risk factors for developing stage 1 or higher AKI were age ≥46 years at the time of transplant (<i>p</i> = 0.001) and use of ≥3 nephrotoxic drugs (<i>p</i> = 0.036). For CKD, the associated risk factors were disease status other than complete remission at the time of transplantation (<i>p</i> = 0.018) and onset of AKI after transplant (<i>p</i> = 0.035). The 5-year overall survival (OS) was significantly reduced by development of AKI (<i>p</i> &lt; 0.001), but not CKD. Posttransplant AKI significantly increased the 5-year nonrelapse mortality (<i>p</i> &lt; 0.001), whereas posttransplant CKD showed an increasing tendency, but the difference was not significant. <b><i>Conclusions:</i></b> Posttransplant AKI impacts OS, significantly increases the risk of CKD, and is significantly associated with disseminated intravascular coagulation and use of ˃3 nephrotoxic drugs.

<b><i>背景：</i></b> 急性肾损伤（Acute kidney injury, AKI）与慢性肾病（Chronic kidney disease, CKD）被认为是异基因造血干细胞移植（allogeneic hematopoietic stem cell transplantation, allo-HSCT）后常见的并发症。<b><i>目的与方法：</i></b> 本研究对114例接受异基因造血干细胞移植的患者进行回顾性分析，旨在探究基于改善全球肾脏病预后组织（Kidney Disease Improving Global Outcomes, KDIGO）新版诊断标准定义的移植后AKI与CKD发病的危险因素。<b><i>结果：</i></b> 共有74例患者（64.9%）发生AKI，25例患者（21.9%）发生CKD。多因素分析显示，移植时年龄≥46岁（p = 0.001）以及使用≥3种肾毒性药物（p = 0.036）是发生1期及以上AKI的危险因素。针对CKD，相关危险因素为移植时未达到完全缓解的疾病状态（p = 0.018）以及移植后AKI发作（p = 0.035）。AKI的发生可显著降低患者5年总生存期（overall survival, OS）（p < 0.001），但CKD未对总生存期产生显著影响。移植后AKI可显著升高患者5年非复发死亡率（p < 0.001），而移植后CKD虽呈升高趋势，但差异无统计学意义。<b><i>结论：</i></b> 移植后AKI会对总生存期造成不良影响，显著升高CKD发病风险，且与弥散性血管内凝血（disseminated intravascular coagulation）以及使用超过3种肾毒性药物显著相关。