Acute Kidney Injury and Childhood Acute Myeloid Leukemia

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 m 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.