Risk Factors for Acute Kidney Injury after Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis

Abstract

Aims: The aim of this study was to identify risk factors associated with acute kidney injury (AKI) after hematopoietic stem cell transplantation (HSCT) by systematically reviewing the relevant literature. Methods: This meta-analysis surveyed relevant articles published in PubMed, Embase, and the Cochrane Library up to December 2022 to identify the reliable risk factors for AKI after HSCT, calculating odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Results: Twenty studies with 4,378 patients were included. Umbilical cord blood transplantation (OR = 2.36; 95% CI: 1.77–3.15; p < 0.00001), calcineurin inhibitors (CNIs) (OR = 1.97; 95% CI: 1.06–3.67; p = 0.03), sinusoidal obstruction syndrome (SOS) (OR = 5.80; 95% CI: 3.96–8.51; p < 0.00001), allogeneic transplantation (OR = 4.27; 95% CI: 1.83–9.95; p = 0.0008), hypertension (OR = 2.07; 95% CI: 1.16–3.69; p = 0.01), amphotericin B (OR = 4.03; 95% CI: 2.54–6.40; p < 0.00001), vancomycin (OR = 2.19; 95% CI: 1.24–3.87; p = 0.007), and total body irradiation (TBI) (OR = 1.81; 95% CI: 1.27–2.57; p = 0.001) were risk factors for AKI. Conclusion: Umbilical cord blood transplantation, CNIs, SOS, allogeneic transplantation, hypertension, amphotericin B, vancomycin, and TBI were risk factors for AKI. It is important for clinical staff to be aware of these risk factors in their treatment planning with patients undergoing HSCT.