Acute kidney injury in critically ill cancer patients is associated with mortality: A retrospective analysis

Abstract

Background In critically ill patients, acute kidney injury (AKI) is common and associated with short-and long-term complications. Our objectives were to describe the epidemiology and impact of AKI in cancer patients admitted to the Intensive Care Unit (ICU). Methods We identified all patients with a haematological malignancy (HM) or solid tumour (ST) who had an emergency admission to the ICU in a tertiary care centre between January 2004 and July 2012. AKI was defined according to the KDIGO criteria. Results 429 patients were included of whom 259 (60%) had AKI. Among HM patients, 73 (78%) had AKI (70% AKI on admission to ICU; 7% during ICU stay); among ST patients, 186 (56%) had AKI (45% on admission to ICU, 11% during ICU stay). ICU and 28-day mortality rates were 33% and 48%, respectively in HM patients, and 22% and 31%, respectively in ST patients. Multivariable analysis showed that AKI was an independent risk factor for both ICU and 28-day mortality. New AKI after 24 hours in ICU was associated with higher mortality than AKI on admission. Conclusions AKI is common in critically ill cancer patients and independently associated with ICU and 28-day mortality.

Veno-venous extracorporeal membrane oxygenation (vv-ECMO) for severe respiratory failure in adult cancer patients: a retrospective multicenter analysis

“…In patients with solid tumors, only serum creatinine had independent prognostic impact in addition to platelet count. This finding in cancer patients with solid tumors is in line with many other studies on a variety of critically ill patients showing that decreased renal function is associated with worse outcome [37,38].…”

“…Furthermore, this study demonstrates that a relevant number of patients (8%) received vv-ECMO despite progression of their malignant disease at the time of ECMO initiation. The decision to initiate vv-ECMO in this setting is intriguing given that tumor progression is generally associated with a poor prognosis [ 36 – 38 ]. This study confirms that progressive disease indicates a very poor prognosis (Fig.…”

<p>Retrospective Study of Acute Kidney Injury Incidence in Patients with Newly Diagnosed Acute Promyelocytic Leukemia</p>

“…15 Therefore, we provide evidence from demographic data regarding the prevalence and risk factors of AKI among patients with newly diagnosed APL. Because the etiology of AKI is significantly associated with the 6-month complete response rate and 28-day mortality, 9 , 16 Identifying patients who are at risk of developing AKI during induction chemotherapy is essential.…”

Molecular Mechanisms and Biomarkers Associated with Chemotherapy-Induced AKI

“…A recent multicenter, observational study showed that 15% of patients admitted to European ICUs have cancer, with solid tumors being more common than hematological cancer (85% vs. 15%, respectively) [ 18 ]. AKI is a severe and frequent complication during critical illness ranging from 54% [ 19 ] to 70% [ 20 , 21 ], and it is particularly common in patients with hematological cancer or multiple myeloma [ 18 , 22 ]. Notably, in most cases, AKI is already present on admission to ICU rather than acquired in ICU [ 21 ].…”

“…AKI is a severe and frequent complication during critical illness ranging from 54% [ 19 ] to 70% [ 20 , 21 ], and it is particularly common in patients with hematological cancer or multiple myeloma [ 18 , 22 ]. Notably, in most cases, AKI is already present on admission to ICU rather than acquired in ICU [ 21 ]. However, reports vary depending on the criteria used to define AKI [ 23 ].…”