Introduction
Acute kidney injury (AKI) is one of the most common complications in children with cancer, including acute myeloid leukemia (AML). A study from Korea reported that among childhood cancer patients, AKI had the highest incidence in patients with AML (88.4%).1 AKI can be a direct effect of the malignancy, a complication of the malignancy, a consequence or adverse effect of chemotherapy, and other medications such as antibiotics or diuretics.2Previous studies have reported that AKI was independently associated with increased mortality, ventilation requirement, hospital length of stay and daily costs.3,4
Childhood AML refers to a heterogeneous group of diseases classified according to morphology, lineage, and genetics.5Globally, AML represents 15%-20% of leukemias in children6 and accounts for 27% of all leukemias in Southern Thailand.7 The overall survival rates of children with AML have seen improvement over the past three decades, from 30-50% to the current 5-year survival rates ranging from 65% to 75%.8,9 Its prognosis depends on age at diagnosis and type of AML, including a range of cytogenetic and molecular characteristics.
Among pediatric cancer patients, the 1-year cumulative incidence of AKI is highest in those with AML1; however, data on the epidemiology of AKI in children with AML are limited. A recent study reported a high incidence of AKI in pediatric AML (64%) with a strong association with age ≥10 years and severe sepsis; however, the sample size was only 58, which restricted the number of variables they could reliably analyze.10 In this study we aimed to retrospectively assess the prevalence of and factors associated with AKI in childhood AML.