Acute Kidney Injury in Myeloid Leukemia of Down Syndrome: Risk Factors and Outcomes

Objective: To identify the risk factors and describe the outcomes of patients who developed acute kidney injury (AKI)during treatment for myeloid leukemia of Down syndrome (ML-DS).Material and Methods: The medical records of 23 Down syndrome patients under the age of 15 who had been diagnosedwith acute myeloid leukemia (AML) and were being treated at a major tertiary care referral facility in Southern Thailandwere reviewed. The identification of factors associated with AKI was done using logistic regression. The Kaplan-Meiermethod was used to calculate survival probabilities.Results: Eight (34.8%) patients developed AKI during their course of chemotherapy with a median time from the firstvisit to the AKI event of 1.1 (IQR 0.7, 3.1) months. Higher levels of blast cells (OR: 1.19, 95% CI: 1.05-1.98) and septicshock during the course of chemotherapy (OR: 621.1, 95% CI: 2.40-Inf.) were independently associated with AKI. The1-year overall survival rate was 26.1%. The median survival times among those who developed AKI and those who didnot were 1.94 and 10.7 months, respectively.Conclusion: About one-third of the cases with ML-DS in our cohort developed AKI during the course of chemotherapy.The risk factors of AKI were higher peripheral blast count and septic shock during chemotherapy.