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 + F8 _; e/ g/ i3 w! C7 d: T

# k( H, h% W7 V: S4 k0 ]Hoffmeister PA. Pediatr Blood Cancer. 2013;doi:10.1002/pbc.24760." ]8 n  k3 v+ u0 r7 _( N
December 2, 20135 w3 W) j+ [* S" y  k
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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.
$ ~/ T8 V2 _9 M# I9 vKidney 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).
( Y0 i' y8 O3 D( g& r1 q" W0 aTo 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.
& B% y* |: i# s4 B& r+ |The researchers used multivariate Cox regression models to assess the HR of risk factors associated with kidney stones.
. }4 E$ u. H% B) |+ W1 eFifty-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%.& u! X* T2 l2 X$ ^' v# t
Risk 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).   E3 }' A- p. N5 Z* Z
Among 868 HSCT survivors, the prevalence of a history of kidney stones was 4.7%.
; Z' Q% n+ n* i( X% @1 G2 SDisclosure: The researchers report no relevant financial disclosures.0 I+ }* r2 |% m% F