Stable renal function in children and adolescents with sickle cell disease after nonmyeloablative hematopoietic stem cell transplantation
Bibliographic record
Abstract
Abstract Background Sickle cell disease (SCD) is associated with renal complications starting as early as infancy. Allogeneic hematopoietic stem cell transplant (HSCT) treatments using newer nonmyeloablative (NMA) conditioning regimens show promising results in treating SCD in the pediatric population, but renal outcome parameters after transplantation have not been described. Aim To describe baseline renal parameters as well as short‐ and long‐term renal outcomes in pediatric patients with SCD who underwent NMA‐HSCT. Methods A retrospective chart review of pediatric patients who received NMA‐HSCT in Alberta, Canada. Short‐term renal outcomes evaluated were: (1) acute kidney injury (AKI), (2) fluid overload (FO), and (3) hypertension. Long‐term outcomes evaluated were: (1) estimated glomerular filtration rate (eGFR) development and at last follow‐up with hyperfiltration defined as eGFR ≥ 150 mL/min/1.73 m 2 , (2) proteinuria, and (3) hypertension. Results The mean follow‐up time was 128.6 weeks (standard deviations, 69.3). No posttransplant AKI events or FO were observed. eGFR remained > 90 mL/min/1.73 m 2 at last follow‐up in all patients, whereas hyperfiltration was present in eight (44.4%) and four (22.2%) patients pre‐ and post‐HSCT, respectively, which are significantly different ( P < 0.0001). Consequently, median GFR was significantly higher pre‐HSCT compared with 24 months HSCT ( P < 0.009). Long‐term hypertension post‐HSCT was present in six patients (33.3%). Conclusion This study describes stable kidney function in children with SCD after NMA‐HSCT without evidence of AKI or FO episodes. Rates of hyperfiltration decreased post‐HSCT, which signifies that NMA‐HSCT could potentially preserve long‐term renal function in this population at risk of progressive chronic kidney disease. Further prospective studies are needed to confirm these novel findings.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".