RESUMO
BACKGROUND AND OBJECTIVES: The burden of acute kidney injury (AKI) has not been explored in Jordanian patients who receive hematopoietic stem cell transplant (HSCT). The aim of this study was to evaluate the frequency, risk factors, and mortality of AKI among patients who underwent HSCT. METHODS: A retrospective pilot study included 70 adult patients who received peripheral HSCT was conducted. Weekly measurement of serum creatinine (SCr) was obtained for 3 months after chemotherapy and HSCT. Then, stages of Risk, Injury, and Failure of Kidney were determined based on the Kidney Disease for Improving Global Outcomes (KDIGO). RESULTS: The median follow-up was 41 months. Mortality was reported in 16 patients (23%). Out of 60 patients that had SCr values, 19 patients (31.6%) had AKI in 90 days after chemotherapy. Allogeneic HSCT, male donors, high-dose melphalan protocols and values of blood urea nitrogen (BUN) were significantly higher among patients with AKI. CONCLUSIONS: Combining many nephrotoxic drugs and dosing adjustments should be considered in uniform protocols. Multidisciplinary care should be utilized to assess early kidney dysfunction that decreases adverse events and improves outcomes.
Assuntos
Adulto , Humanos , Masculino , Injúria Renal Aguda , Nitrogênio da Ureia Sanguínea , Vestuário , Creatinina , Tratamento Farmacológico , Seguimentos , Células-Tronco Hematopoéticas , Incidência , Jordânia , Rim , Nefropatias , Melfalan , Mortalidade , Projetos Piloto , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Doadores de TecidosRESUMO
A 20-month old boy delivered to a consanguineous parents presented early in the infantile period with deep jaundice, his investigations showed progressive cholestatic jaundice, high liver enzymes and high GGT. Hepatitis and metabolic errors were excluded. The liver biopsy showed a prominent parenchymal bile stasis without features of bile obstruction or an evidence of paucity of bile ducts. These findings are going with the diagnosis of Byler Disease or progressive familial intrahepatic cholestasis [PFIC3] which is a chronic cholestasis syndrome that begins in infancy and usually progresses to cirrhosis and hepatic failure in the first few years of life. Few patients have survived into the third decade of life without treatment. Liver transplantation is the only effective treatment for this type of the disease