Date of Completion of Thesis/SIP

Spring 5-15-2022

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

First Advisor

Diane Forsyth

Second Advisor

Kimberly Langer

City

Rochester, Minnesota

Abstract

Hematopoietic stem cell transplant (HSCT) patients are at risk to develop acute kidney injury during the transplant process. Acute kidney injury (AKI) can occur due to a multitude of insults related to nephrotoxic medications, hypoperfusion, and dehydration. Additionally, patients who present for HSCT may have risk factors that could pose an increased risk of developing AKI which include chronic kidney disease, hematologic disease, type of transplant, conditioning chemotherapy, and poor pretransplant renal testing. The purpose of this secondary analysis was to identify the contributing factors that may influence the development of AKI, understand the relationships between the variables, and identify the incidence of AKI that leads to dialysis or prevalence of CKD in adult HSCT patients. The primary dataset included 1,550 HSCT patients at a large, midwestern academic medical center collected between 2017 and 2019. Of the 1,550 patients in the initial dataset, approximately 474 patients were found to have AKI based on post-transplant data. The theoretical framework, Theory of Unpleasant Symptoms, relates to the variables, contributing risk factors, and outcomes from the study. From the secondary analysis of the data, several results were significant which includes donor type, disease class, chemo type, and types of transplants. Significance was seen with relationship between AKI and developing CKD. The relationship between the stage of AKI and whether patients were on dialysis was statistically significant. Recommendations include using a standardized method to define, evaluate and treat AKI, monitor subtle creatinine changes, and standardize use of the HCT-CI to evaluate patient’s risk of developing complications including AKI.

Available for download on Tuesday, May 20, 2025

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