Onco-Nefrología: cáncer, quimioterapia y riñón

Francisco, A.L.M. de; Macía, Manuel; Alonso, Fabiola; García, Patricia; Gutiérrez, Eduardo; Quintana, Luís F.; Quiroga, Borja; Torregrosa, Isidro

doi:10.1016/j.nefro.2018.10.016

Cited by 26 publications

(16 citation statements)

References 29 publications

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“…Adapted from Dong et al . [ 63 ] and Francisco Alm and Canga [ 64 ]. a Beware of increased risk of long QT–associated arrhythmia, especially if both are associated.…”

Section: Prevention and Treatment Of Covid-19 In Ckdmentioning

confidence: 99%

Coronavirus disease 2019 in chronic kidney disease

D’Marco

Puchades

Romero-Parra

et al. 2020

Clinical Kidney Journal

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The clinical spectrum of coronavirus disease 2019 (COVID-19) infection ranges from asymptomatic infection to severe pneumonia with respiratory failure and even death. More severe cases with higher mortality have been reported in older patients and in those with chronic illness such as hypertension, diabetes or cardiovascular diseases. In this regard, patients with chronic kidney disease (CKD) have a higher rate of all-type infections and cardiovascular disease than the general population. A markedly altered immune system and immunosuppressed state may predispose CKD patients to infectious complications. Likewise, they have a state of chronic systemic inflammation that may increase their morbidity and mortality. In this review we discuss the chronic immunologic changes observed in CKD patients, the risk of COVID-19 infections and the clinical implications for and specific COVID-19 therapy in CKD patients. Indeed, the risk for severe COVID-19 is 3-fold higher in CKD than in non-CKD patients; CKD is 12-fold more frequent in intensive care unit than in non-hospitalized COVID-19 patients, and this ratio is higher than for diabetes or cardiovascular disease; and acute COVID-19 mortality is 15–25% for haemodialysis patients even when not developing pneumonia.

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“…Adapted from Dong et al . [ 63 ] and Francisco Alm and Canga [ 64 ]. a Beware of increased risk of long QT–associated arrhythmia, especially if both are associated.…”

Section: Prevention and Treatment Of Covid-19 In Ckdmentioning

confidence: 99%

Coronavirus disease 2019 in chronic kidney disease

D’Marco

Puchades

Romero-Parra

et al. 2020

Clinical Kidney Journal

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“…There is controversy in the literature as the type of contrast to use in oncologic patients in order to preserve renal function. Some authors propose the use of iso-osmolar contrast in these patients, as it is less harmful to the kidney [23].However, most radiological and clinical guidelines consider that this protection is not proven, especially when the route of administration is intravenous [11][20] [24]. Werner et al published the rst series investigating the incidence of PC-AKI with elective CE-CT in oncologic patients with CKD IIIb receiving oral hydration prophylaxis and iso-osmolar contrast, and reported 4.2% of patients developing PC-AKI [25].…”

Section: Discussionmentioning

confidence: 99%

“…Dehydration is common in oncologic patients due to many factors associated with cancer itself and its treatment [23].…”

Section: Discussionmentioning

confidence: 99%

Oral hydration as a safe prophylactic measure to prevent post-contrast acute kidney injury in oncologic patients with chronic kidney disease (IIIb) referred for contrast-enhanced computed tomography: subanalysis of the oncological group of the NICIR study

Sebastiá

Páez-Carpio

Guillén

et al. 2021

Support Care Cancer

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BackgroundThe objective of this study is to evaluate oral hydration compared to intravenous (i.v.) hydration in the prevention of post-contrast acute kidney injury (PC-AKI) in the oncologic subgroup of patients with stage IIIb chronic kidney disease (CKD) included in the NICIR study referred for elective contrast-enhanced computed tomography (CE-CT). Material and MethodsWe performed a retrospective subanalysis of the oncological subgroup (174/228 patients, 74%) from a continuous prospective database of patients included in the recently published non-inferiority NICIR study. Patients received prophylaxis against PC-AKI with either oral hydration (500 mL of water two hours before and 2000 mL during the 24 hours after CE-CT) or i.v. hydration (sodium bicarbonate (166 mmol/L)3 mL/kg/h starting one hour before and 1 mL/kg/h during the rst hour after CE-CT). The primary outcome was to compare the proportion of PC-AKI in the rst 48 to 72 hours after CE-CT in the two hydration groups. Secondary outcomes were to compare persistent PC-AKI, the need for hemodialysis, and the occurrence of adverse events related to prophylaxis in each group. ResultsOf 174 patients included in the subanalysis, 82 received oral hydration and 92 received i.v. hydration. There were no signi cant differences in clinical characteristics or risk factors between the two study arms. Overall the PC-AKI rate was 4.6% (8/174 patients), being 3.7% in the oral hydration arm (3/82 patients) and 5.4% (5/92 patients) in the i.v. hydration arm. The persistent PC-AKI rate was 1.8% (1/82 patients) in the oral hydration arm and 3.3% (3/92 patients) in the i.v. hydration arm. No patient required dialysis during the rst month after CE-CT or had adverse effects related to the hydration regime. ConclusionIn oncological patients with stage IIIb CKD referred for elective CE-CT, the rate of PC-AKI in those receiving oral hydration did not signi cantly differ from that of patients receiving i.v. hydration.

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“…Thirdly, there are other aetiological factors in cancer patients beyond those described in our study that may affect renal function, such as prior and/or concomitant nephrotoxic drugs, other pathologies or dialysis. (de Francisco et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Administration of iodinated contrast: What is the risk in cancer patients?

Cervantes

Martínez²,

Arana

2020

Eur J Cancer Care

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Objective Despite the association between intravenous contrast and kidney injury, few studies exist in oncology. Our objective was to estimate kidney outcomes following iodinated contrast‐enhanced computed tomography (CECT) in cancer patients, and to evaluate whether self‐assessment questionnaires can identify kidney injury risk factors. Methods This prospective observational study included 289 patients who underwent a CECT scan between March and May 2017 in a hospital setting. All patients completed the modified European Society of Urogenital Radiology (ESUR) questionnaire and had an estimated glomerular filtration rate (eGFR) >30 ml/min/1.73 m2 on the day of the examination. Outcomes were followed for 4 months. Univariate and logistic regression analyses were carried out. Results In the logistic regression analysis, the only variables statistically associated with deterioration in the eGFR were age, (odds ratio (OR) = 1.091, p = 0.003), female sex, (OR 0.22, p = 0.020) and arterial hypertension (AH), (OR = 3.57, p = 0.019). Regarding exitus, only the group with a worse eGFR was close to predictive statistical significance (OR = 2.48, p = 0.09). Conclusions The administration of iodinated contrast in cancer patients was not associated with an increase in kidney outcomes. Risk factors in these patients were age, sex and AH.

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Onco-Nefrología: cáncer, quimioterapia y riñón

Cited by 26 publications

References 29 publications

Coronavirus disease 2019 in chronic kidney disease

Coronavirus disease 2019 in chronic kidney disease

Oral hydration as a safe prophylactic measure to prevent post-contrast acute kidney injury in oncologic patients with chronic kidney disease (IIIb) referred for contrast-enhanced computed tomography: subanalysis of the oncological group of the NICIR study

Administration of iodinated contrast: What is the risk in cancer patients?

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