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
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  z+ B* @" V; g) `* PHoffmeister PA. Pediatr Blood Cancer. 2013;doi:10.1002/pbc.24760.0 Y2 s# O, c. m8 i! S4 g* ?3 r3 j8 m$ w
December 2, 2013
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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.4 r; p4 w, U2 _: \3 i
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 U& P/ C% k9 k( B( e" W* g
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.
9 F7 H+ g0 ?% }2 U) F7 _! z' f: JThe researchers used multivariate Cox regression models to assess the HR of risk factors associated with kidney stones.) i+ V3 ~% E: ?
Fifty-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%.
' \& N, {* \( e* QRisk 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 E* K; J3 O7 r% E4 zAmong 868 HSCT survivors, the prevalence of a history of kidney stones was 4.7%.
: j7 w" ]' a* Z  C, N+ j3 G# ]Disclosure: The researchers report no relevant financial disclosures.
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