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.