Objective: To analyze clinical characteristics and prognostic factors of patients with malignancies combined with acute kidney injury (AKI), providing a basis for clinical AKI prevention and prognosis improvement.
Method: Hospitalized patients in the Central Hospital of Nephrology from January 2008 to December 2013 were screened by electronic medical record system; Statistical analysis formalignant tumor patients associated with AKI was conducted. The clinical features of these patients in 6 years were analyzed and compared, and Logistic regression analysis was used to analyze the risk factors of hospitalized mortality in patients with and malignant tumor and AKI.
Results: There were 340 cases of malignancies associated with AKI patients, accounting for 30.0% (340/1133) of AKI patients in the same period. In malignancy patients, hematological malignancies accounted for 12.9% (44/340); non-metastatic solid tumor accounted for 54.7% (186/340); metastatic solid tumor accounted for 32.4% (110/340). In factors leading to AKI, post-renal obstruction [60% (204/340)], nephrotoxic drugs or contrast agents [27.9% (95/340)] and hypovolemia [41/340 (12.1%)] were common in patients with malignant tumors. There was no significant difference in the cause of AKI between early 3 years and later 3 years (P>0.05). Hospital mortality in patients with malignancies associated with AKI was [22.9% (78/340)], with an annually declining trend. Multivariate Logistic regression showed that: multiple etiologies, multiple organ failure, metastatic solid tumor, sepsis, and continuous renal replacement therapy were independent risk factors for hospital mortality.
Conclusion: AKI is a common complication in patients with malignant tumors, with post-renal obstruction as the most common factors. Hospital mortality in malignant tumor patients associated with AKI was higher, and the prevention of AKI is crucial in clinical.
Keywords: Acute kidney injury; prognosis; risk factor; tumor.