Prevalence of Acute Kidney Injury After Hematopoietic Stem Cell Transplantation in Pediatric Populations: A Systematic Review and Meta-Analysis Publisher



Jabermoradi S ; Paridari P ; Mohammadi A ; Karimi N ; Mardani M ; Fazel M ; Ataei N ; Gharin P ; Ramawad HA ; Hosseini M ; Yousefifard M
Source: Archives of Academic Emergency Medicine Published:2026

Abstract

Background: The prevalence of acute kidney injury (AKI) associated with hematopoietic stem cell transplantation (HSCT) is well-established in the adult population. Similarly, AKI following HSCT is frequently encountered in the pediatric population. However, adequate information regarding the prevalence among children and adolescents is lacking. We conduct a systematic review to investigate the current literature specifically addressing the prevalence of AKI in children treated with HSCT. Methods: An extensive search was performed using Medline, Embase, Scopus, and Web of Science databases until May 5, 2025. We systematically reviewed and included all clinical trials and observational studies. Two independent researchers screened the studies, recorded the required data, and assessed the risk of bias. The studied outcomes included the prevalence of AKI and the need for renal replacement therapy (RRT). The data included were analyzed in the STATA 18.0 statistical program. Results: Forty-nine articles were eligible for inclusion. The prevalence of pediatric AKI after HSCT was 34.18% (95% confidence interval (CI): 28.08 to 40.53; I2=97.79%). The need for RRT following HSCT was equal to 3.54% (95% CI: 1.98 to 5.45; I2= 95.10%). The origin of hematopoietic stem cells and AKI determination cutoff points were found to be the most predictive of AKI prevalence. The prevalence of AKI after transplantation of hematopoietic cells derived from umbilical cord blood was significantly higher than other cell sources (69.55%; 95% CI: 22.23, 100.0). Conclusion: The prevalence of pediatric AKI and RRT after hematopoietic cell transplantation is significant, and is 34.18% and 3.54%, respectively. The highest prevalence of AKI among the different sources of hematopoietic stem cells was observed in cord blood transplantation. However, the available evidence on the prevalence of AKI following the transplantation of hematopoietic stem cells derived from cord blood is insufficient, and more research is needed in this field. As a suggestion, it is recommended to use sources other than hematopoietic cells derived from umbilical cord blood until sufficient evidence is available. © 2026 Shaheed Beheshti University of Medical Sciences and Health Services. All rights reserved.