童年造血幹細胞移植腎結石風險增加

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Childhood HSCT increased risk for kidney stones , t5 B$ h3 _, E' H2 y% U8 ~+ e
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Hoffmeister PA. Pediatr Blood Cancer. 2013;doi:10.1002/pbc.24760.' X3 [; b1 d- ]# g% S5 Z
December 2, 2013' E/ m8 O* X' d0 b2 T

# N8 n& O3 g( F  p2 ~Patients who received hematopoietic stem cell transplantation as part of childhood cancer treatment exhibited an increased risk of developing kidney stones as adults, according to results of a retrospective study.# q' V, i- \/ k3 a) X
Kidney stones are known to develop in patients treated for childhood cancer, but previous studies have not established the association in children who undergo hematopoietic stem cell transplantation (HSCT).5 O5 t- S0 a4 C4 U0 t! a& ~8 @
To determine risk factors for the development of kidney stones and to illustrate its prevalence among HSCT survivors, researchers examined 1,343 children who underwent HSCT. Of them, 360 received a long course of methotrexate for acute graft-versus-host disease prophylaxis, 626 received a short course and 357 received none.( F0 \$ r% l: v
The researchers used multivariate Cox regression models to assess the HR of risk factors associated with kidney stones.
4 s- J3 c- r' v$ Z6 v7 kFifty-one patients developed kidney stones. They developed a median 9.9 years (range, 0.2-29.4) after first HSCT. Researchers reported a 30-year cumulative incidence of 7.4%.
$ V& Y% h- X8 W: h9 s+ ]/ D, SRisk factors associated with kidney stones were total body irradiation (HR=2.2; P=.03), age at HSCT (12-18 years vs. <6 years, HR=2.7; P=.01), methotrexate treatment (long course vs. none, HR=3.6; P=.02) and prednisone (HR=2.2; P=.008).
8 x1 ?1 H" D8 F; B; z. d" ]  pAmong 868 HSCT survivors, the prevalence of a history of kidney stones was 4.7%./ T3 H7 T: q& l/ x+ b4 W
Disclosure: The researchers report no relevant financial disclosures.$ ]0 Q. I" R& w! x& x  |, i