Background: Bone marrow transplantation (BMT) is a major modality for malignant and hematologic disorders. This procedure is associated with a high morbidity and mortality such as acute kidney injury (AKI). Many factors, such as therapeutic agents, irradiation, and graft versus host disease (GVHD) can cause AKI. Bone marrow transplantation conditioning therapy in egypt is based on drugs such as busulfan and cyclo phosphamide with and without irradiation therapy. The aim of this study was to evaluate the risk factors for AKI among patients who underwent BMT. Methods: One hundred patients were rertospectively studied from time of transplant till 3 months after. Acute renal failure (ARF) was defined as a doubling of baseline serum creatinine at any time during the first 100 days post-transplant. We conducted a case-control study to identify precipitants of ARF. For each person who developed ARF, one controls were selected at random from patients who had not developed ARF as of that time. An exposure period was defined for each case as the 2 weeks prior to the day on which the matched case met the criteria for ARF. The risk of ARF in relation to demographic and anthropometric characteristics, comorbidity, types of treatment and post transplant complications was examined using univariable and multivariable conditional logistic regression models. Odds ratios for the associations with ARF were estimated, taking into account the matching. Results: Fifty patients (50%) developed ARF at a mean 11.8 ± 6.1 days after myeloablativetrans plant versus 9.8 ± 4.1 days among non-myeloablative transplant ( p=0.17). Elevated risks were observed in patients who were hypertensive (OR 4.25; 95%CI 1.45–29.95) ,patient who had post transplant ICU admission (OR 7.57;95%CI 0.79–16.55), those with sinusoidal obstruction syndrome (SOS) (OR 4.16; 95%CI 2.29–38.38), high cyclosporine trough level (OR 2.96;95%CI 0.79–16.55) , and those with post transplant weight gain (OR 2.95;95%CI 0.79–16.55). Neither graft versus host disease (GVHD), nor CMV reactivation was associated with an increased risk of ARF. Conclusion: The cumulative incidence of ARF after HCT remains high. Cyclosporine trough level and presence of hepatic sinuosoidal injury increased the risk of ARF within the first 100 days after HCT. Higher levels of serum creatinine at baseline were associated with a higher risk of ARF.
