{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:22:53Z","timestamp":1787743373040,"version":"build-2784847793"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pediatric hematopoietic stem cell transplantation (HSCT) is curative for malignant and non\u2010malignant diseases, yet survivors remain at substantial risk for late renal complications. Data on chronic kidney disease (CKD) incidence and its determinants in pediatric HSCT recipients are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a single\u2010center retrospective cohort study of 261 pediatric patients (aged 0\u201321\u2009years) who underwent HSCT at Schneider Children's Medical Center, Israel, between 2000 and 2020. Acute kidney injury (AKI) was defined per KDIGO creatinine criteria. CKD was defined as eGFR &lt;\u200990\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      sustained \u2265\u20093\u2009months and\/or proteinuria or hypertension. Given the limited number of CKD events, multivariable logistic regression identifying factors associated with CKD was treated as exploratory. Overall survival was analyzed using Kaplan\u2013Meier methodology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      AKI episodes occurred in 20.5% of patients during the first three months post\u2010HSCT. CKD incidence increased progressively: 6.0% at one year, 8.6% at three years, and 16.5% at five years\u2010substantially exceeding the ~5% background prevalence reported in the general Israeli pediatric population. Older age at transplantation was the only variable significantly associated with CKD in this exploratory model (mean 11.96 vs. 7.12\u2009years in the CKD and non\u2010CKD groups, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). A higher proportion of patients who developed CKD had undergone four or more transplantations compared with those who did not (31.6% vs. 3.7%), though this difference did not reach statistical significance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.22) and should be regarded as hypothesis\u2010generating. Patients with a borderline baseline creatinine in the early post\u2010transplant period had lower overall survival than those with a normal baseline creatinine (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05), an association whose biological basis requires further study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CKD affects a substantial and growing proportion of pediatric HSCT survivors in this cohort, particularly those transplanted at older ages. These findings are associative rather than causal, given the retrospective, single\u2010center design and limited number of CKD events. They nonetheless support systematic long\u2010term renal surveillance and nephrology referral as part of post\u2010HSCT survivorship care, with prospective, adequately powered studies needed to confirm risk factors and clarify mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70417","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T10:08:12Z","timestamp":1786529292000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the Transplant: Chronic Kidney Disease in Pediatric Hematopoietic Stem Cell Transplant Survivors\u2010A 20\u2010Year Single\u2010Center Cohort Study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4811-7665","authenticated-orcid":false,"given":"Alcotzer","family":"Inbar","sequence":"first","affiliation":[{"name":"Gray Faculty of Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talgam\u2010Horshi","family":"Efrat","sequence":"additional","affiliation":[{"name":"Schneider Children's Medical Center  Petach Tiqva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1406-0165","authenticated-orcid":false,"given":"Sidlik Muskatel","family":"Rakefet","sequence":"additional","affiliation":[{"name":"Gray Faculty of Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Schneider Children's Medical Center  Petach Tiqva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kraus","family":"Aviva","sequence":"additional","affiliation":[{"name":"Gray Faculty of Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Schneider Children's Medical Center  Petach Tiqva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanir","family":"Assaf","sequence":"additional","affiliation":[{"name":"Gray Faculty of Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Schneider Children's Medical Center  Petach Tiqva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahel","family":"Anat","sequence":"additional","affiliation":[{"name":"Schneider Children's Medical Center  Petach Tiqva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-6956","authenticated-orcid":false,"given":"Stein","family":"Jerry","sequence":"additional","affiliation":[{"name":"Gray Faculty of Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Schneider Children's Medical Center  Petach Tiqva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1869-3282","authenticated-orcid":false,"given":"Levy\u2010Erez","family":"Daniella","sequence":"additional","affiliation":[{"name":"Gray Faculty of Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Schneider Children's Medical Center  Petach Tiqva Israel"},{"name":"Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1404711"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30537-0"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-90281-4_8"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-022-05731-x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2017.11.021"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2016.05.005"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705573"},{"issue":"11","key":"e_1_2_9_9_1","first-page":"1997","article-title":"Hematopoietic Stem Cell Transplantation and Acute Kidney Injury in Children: A Comprehensive Review","volume":"32","author":"Raina R.","year":"2017","journal-title":"Pediatric Nephrology"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12483"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.01926"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-022-05714-y"},{"issue":"1","key":"e_1_2_9_13_1","first-page":"1","article-title":"KDIGO Clinical Practice Guideline for Acute Kidney Injury","volume":"2","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group","year":"2012","journal-title":"Kidney International. Supplement"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-11-201306040-00007"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2016.03.014"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-020-04842-7"},{"issue":"6","key":"e_1_2_9_17_1","first-page":"1371","article-title":"Chronic Kidney Disease Ten Years After Pediatric Allogeneic Hematopoietic Stem Cell Transplantation","volume":"100","author":"Lugthart G.","year":"2021","journal-title":"Kidney International"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70417","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.70417","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70417","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:57:46Z","timestamp":1787741866000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70417"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":16,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/petr.70417"],"URL":"https:\/\/doi.org\/10.1111\/petr.70417","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70417"}}