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 " y5 A1 G5 f$ z+ v3 F6 |% G4 i
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Hoffmeister PA. Pediatr Blood Cancer. 2013;doi:10.1002/pbc.24760.( s) ~' A  _( X; F2 C
December 2, 2013/ M6 }4 q7 j- m+ L$ C
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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.
9 J$ r# |- W( |8 i6 J) F; I/ lKidney 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).
- A" m5 e5 e4 RTo 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.. u4 Y, Q. q9 a- Q6 ^! x' }
The researchers used multivariate Cox regression models to assess the HR of risk factors associated with kidney stones.: A- r  c1 N) z
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%.
5 ^  @2 |2 x0 \. @0 BRisk 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).
9 F) Y# A0 _% @0 R) {' s6 w% r0 h1 kAmong 868 HSCT survivors, the prevalence of a history of kidney stones was 4.7%.
, e0 A" v4 X* o% h4 b+ sDisclosure: The researchers report no relevant financial disclosures.
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