Preventive strategies for acute kidney injury in cancer patients

Abstract

Acute kidney injury (AKI) is a common complication of cancer that occurs in up to 50% of neoplastic patients during the natural history of their disease; furthermore, it has a huge impact on key outcomes such as overall prognosis, length of hospitalization and costs. AKI in cancer patients has different causes, either patient-, tumour- or treatment-related. Patient-related risk factors for AKI are the same as in the general population, whereas tumour-related risk factors are represented by compression, obstruction, direct kidney infiltration from the tumour as well by precipitation, aggregation, crystallization or misfolding of paraprotein (as in the case of multiple myeloma). Finally, treatment-related risk factors are the most common observed in clinical practice and may present also with the feature of tumour lysis syndrome or thrombotic microangiopathies. In the absence of validated biomarkers, a multidisciplinary clinical approach that incorporates adequate assessment, use of appropriate preventive measures and early intervention is essential to reduce the incidence of this life-threatening condition in cancer patients.

Acute Kidney Injury in Patients With Suspected Pulmonary Embolism: A Retrospective Study of the Incidence, Risk Factors, and Outcomes in a Tertiary Care Hospital in Saudi Arabia

“…We hypothesize the reason might be due to a complication of cancer or the treatment. Patients with cancer are at higher risk of developing infections, sepsis, tumor lysis syndrome, and drug-associated toxicity that significantly increase the risk of developing AKI [25][26][27]. Other reported factors associated with AKI were heart failure, atrial fibrillation, hematological disorders, and massive/severe PE [7,10,13].…”

Extracellular vesicles derived from mesenchymal stem cells as a potential therapeutic agent in acute kidney injury (AKI) in felines: review and perspectives

“…It is worth to note that certain cancers like leukemias, lymphomas, multiple myelomas (MM) and renal cell cancer (RCC) in both human and veterinary patients are related with the higher risk of AKI development, not only due to the accompanying kidney involvement, but also due to the hypotension, sepsis, administration of different anti-fungal and anti-bacterial agents, cytotoxic or immunosuppressive drugs and even hematopoietic stem cell transplantation (HSCT) and tumor lysis syndrome (TLS). The appropriate scheme of cancer treatment seems to be an ideal preventive strategy from AKI development [70].…”

Expert consensus of perioperative intensive care and management of critically ill cancer patients (2021)

“…Another study from China showed that there were 1,418 malignancy-related AKI in 7,604 AKI patients according to KDIGO criteria (25). Both patient-specific and cancer-related risk factors including age, co-morbid conditions, chemotherapy, surgery and radiotherapy increase the risk of AKI in cancer patients (26). Critically ill cancer patients with AKI had increased mortality compared patients without AKI (27).…”