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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; V. W0 i( C$ DHoffmeister PA. Pediatr Blood Cancer. 2013;doi:10.1002/pbc.24760.
& G# b8 _  P# Z, C0 [December 2, 2013
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; }+ t" v( a) F, P: y+ M) h$ _2 g7 lPatients 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.; R* N8 G, G# Q9 D
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).& w$ n) ~9 [1 S5 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.
8 T# S6 g+ T. x- N: N7 j& GThe researchers used multivariate Cox regression models to assess the HR of risk factors associated with kidney stones.5 k5 d; Q/ N8 D. z0 h6 j
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%.
( e- j2 k1 z, ?3 A4 R4 o) A  lRisk 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).
" x2 a6 ~, z% P" P3 E% b9 C/ p: z1 CAmong 868 HSCT survivors, the prevalence of a history of kidney stones was 4.7%.& r& y7 u5 e+ Q7 X% d# p/ n+ e- G
Disclosure: The researchers report no relevant financial disclosures./ j9 j$ a( s4 Q$ }! |: k) V