Effects of induction-phase acute kidney injury and age at diagnosis on chronic kidney disease in pediatric acute lymphoblastic leukemia: a time-to-event cohort study

BACKGROUND: The survival rate of pediatric acute lymphoblastic leukemia (ALL) currently exceeds 90% in high-income settings, shifting the focus to its long-term effects. Kidney injury, acute kidney injury (AKI), and chronic kidney disease (CKD) are increasingly recognized associated conditions; however, the determinants of CKD in pediatric ALL remain poorly defined. PURPOSE: To quantify the burden of AKI during induction and CKD in children with ALL, estimate CKD-free survival, and identify clinical predictors of CKD. METHODS: This retrospective cohort at a single university-affiliated tertiary center included patients aged 2-18 years with ALL who completed ≥3 months of follow-up. AKI was classified by Kidney Disease: Improving Global Outcomes serum-creatinine criteria, while CKD was defined as a glomerular filtration rate