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 ! _$ O5 y# o( c  X7 x
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Hoffmeister PA. Pediatr Blood Cancer. 2013;doi:10.1002/pbc.24760.
, T; j9 R3 p6 sDecember 2, 2013  \% ^& d- D! W4 |6 v

; u/ G. K/ U% g% f2 FPatients 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 [2 d/ P& P0 U9 H  V7 R. p8 U2 _3 p
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).
& n$ t0 K% y; L4 Z; m! z4 MTo 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 T1 n8 U9 g2 T" e( q1 IThe researchers used multivariate Cox regression models to assess the HR of risk factors associated with kidney stones.
& Y4 C( f3 U# c3 t; ~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%.
  e7 g6 ~# h  oRisk 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).
! r1 L; c5 r, J" E1 }5 |: gAmong 868 HSCT survivors, the prevalence of a history of kidney stones was 4.7%.
+ T& p3 S; y1 q5 O1 H  aDisclosure: The researchers report no relevant financial disclosures.9 e0 f  C: {) p7 d. {3 s4 X