ACUTE KIDNEY INJURY IN CHILDREN WITH LEUKEMIA

Abstract

THE AIM. Evaluation of frequency and course of acute kidney injury (AKI) in children with leukemia at the different stages of therapy. PATIENTS AND METHODS. In our study we included 143 children with different variants of leukemia receiving polychemiotherapy (PCHT) at oncohematolological unit of VRCH №1 for the period from 01.2008 to 01.2014 year. The observation was conducted at 4 stages: before polychemiotherapy (PCHT), during intensive PCHT, during maintaining PCHT, after the end of the treatment during stable remission. AKI was diagnosed with regard to the level of glomerular filtration rate (GFR) and serum creatinine which were decreased and increased respectively minimum in 1.5 times (25%). RESULTS: We diagnosed AKI in 109 children (76,2 %) from 143 observed patients, Risk stage was found in 44 children (30,8 %), the stage of Injury – in 46 children (32,2 %), the stage of Failure – in 19 children (13,3%). AKI was noted at all phases of chemotherapy, maximum at the stage of intensive PCHT (in 77 from 89 children, 86,5 %). In 16 from 30 children (53,3 %) observed during all phases of treatment AKI registered several times (maximum 4 times). During the period of observation the fatal outcome was registrated in 20 children (more often in the period of intensive PCHT); all of them had moderate and severe stages of AKI: 8 patients – stage Injury, 12 – stage Failure. CONCLUSION. AKI was registrated quite often in children with leukemia, the most frequent at the stage of intensive PCHT. Development of AKI aggravates prognosis of leukemia in children in relation to survival. The patient with leukemia can develop AKI several times during different stages of PCHT and after the end of treatment.