Related Experiment Video
Updated: Oct 1, 2025
Bilateral Renal Ischemia-Reperfusion Model for Acute Kidney Injury in Mice
Published on: February 2, 2024
Acute kidney injury and childhood acute myeloid leukemia
Chompoonut Limratchapong1, Praewa Sophark1, Prayong Vachvanichsanong1
1Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkla, Thailand.
Insights
Fifty percent of children with acute myeloid leukemia (AML) develop acute kidney injury (AKI) during treatment. Older age at diagnosis, pre-existing kidney problems, and septic shock increase AKI risk in pediatric AML patients.
Area of Science:
- Pediatric Oncology
- Nephrology
- Epidemiology
Background:
- Acute kidney injury (AKI) is a significant concern in pediatric patients diagnosed with acute myeloid leukemia (AML).
- Epidemiological data on AKI incidence in this specific population is limited.
- Understanding AKI prevalence and associated factors is crucial for optimizing treatment and patient outcomes.
Purpose of the Study:
- To determine the prevalence of acute kidney injury (AKI) in children undergoing chemotherapy for acute myeloid leukemia (AML).
- To identify clinical and demographic factors associated with the development of AKI in this patient group.
Main Methods:
- Retrospective review of medical records for 112 children under 15 years old diagnosed with AML.
- Analysis of chemotherapy treatment data and patient demographics.
- Logistic regression modeling to identify independent predictors of AKI.
Main Results:
- 50% of the pediatric AML patients experienced at least one episode of AKI.
- Independent factors associated with AKI included age ≥ 10 years at diagnosis (OR 2.75), glomerular filtration rate < 90 mL/min/1.73 m² at diagnosis (OR 7.58), and septic shock (OR 22.0).
- The median time to the first AKI event was 29.5 days post-AML diagnosis.
Conclusions:
- Childhood AML is associated with a high incidence of AKI, affecting half of the patients.
- Key risk factors for AKI in pediatric AML include older age at diagnosis, pre-existing renal impairment, and the occurrence of septic shock.
- These findings highlight the need for vigilant renal function monitoring in pediatric AML patients, especially those with identified risk factors.
Background:
Acute kidney injury (AKI) appears to be particularly common in children with acute myeloid leukemia (AML), although the epidemiology data on this patient population is sparse. The objective of this study was to assess the prevalence and factors associated with AKI in childhood AML during chemotherapy treatment.
Methods:
The medical records of 112 children aged under 15 years diagnosed with AML who received chemotherapy in a major tertiary-care referral center in southern Thailand were reviewed. Logistic regression was used to identify factors associated with AKI.
Results:
Fifty-six (50%) children had AKI events. The median time from AML diagnosis to the first AKI was 29.5 days (interquartile range: 11.0-92.8) and the median follow-up time was 10.9 months (interquartile range: 3.6-31.1). Age at diagnosis ≥ 10 years (OR 2.75, 95% CI 1.09-6.93), glomerular filtration rate < 90 mL/min/1.73 m2 at AML diagnosis (OR 7.58, 95% CI 1.89-30.5), and septic shock (OR 22.0, 95% CI 4.63-104.3) were independently associated with AKI.
Conclusions:
Childhood AML has a high rate of kidney injury with 50% having AKI. Age ≥ 10 years at diagnosis, impaired kidney function before treatment, and septic shock were strongly associated with AKI. A higher resolution version of the Graphical abstract is available as Supplementary information.
Related Concept Videos
01:22Acute Kidney Injury I: Introduction
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:29Acute Kidney Injury II: Pathophysiology
01:29Acute Kidney Injury III: Clinical Manifestations
01:20Acute Kidney Injury V: Interprofessional Care
01:22Acute Kidney Injury VI: Nursing Management