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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Hoffmeister PA. Pediatr Blood Cancer. 2013;doi:10.1002/pbc.24760.+ i4 o5 [2 H/ @4 B* n5 p% z% _
December 2, 20136 {9 V, b+ ?# z7 A# b7 J

9 y6 {2 C: Y6 HPatients 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.
- J# J+ n% i% A4 C5 p1 l7 t8 k( JKidney 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).& ]0 w& v* H+ }+ J5 v
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 U* ~' y" o# _  K% h& iThe researchers used multivariate Cox regression models to assess the HR of risk factors associated with kidney stones.
* B) v4 N7 j+ c! wFifty-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%.  p( ~! h8 _6 H. r3 i. `# d1 W0 f0 N
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).
* X- u$ Q1 X; c3 T& t1 h5 ^$ oAmong 868 HSCT survivors, the prevalence of a history of kidney stones was 4.7%.0 r( Q3 ]* U/ @! V- Z. N) A
Disclosure: The researchers report no relevant financial disclosures.' u3 g5 Y0 q' j3 e7 u3 T5 }: h" g