Incidence, Patterns, and Characteristics of Patients With Acute Kidney Injury Requiring Renal Replacement Therapy in Cancer Settings

Summra Siddiq; Zakia Hussain; Janmohamed Mubarakali; Anam Nazir

doi:10.7759/cureus.48627

Incidence, Patterns, and Characteristics of Patients With Acute Kidney Injury Requiring Renal Replacement Therapy in Cancer Settings

Cureus. 2023 Nov 10;15(11):e48627. doi: 10.7759/cureus.48627. eCollection 2023 Nov.

Authors

Summra Siddiq¹, Zakia Hussain², Janmohamed Mubarakali³, Anam Nazir⁴

Affiliations

¹ Department of Nephrology, King's College Hospital, London, GBR.
² Department of Gynecology and Obstetrics, Royal Stoke University Hospital, Stoke-on-Trent, GBR.
³ Department of Nephrology, New Cross Hospital, Wolverhampton, GBR.
⁴ Department of Internal Medicine, Pakistan Kidney and Liver Institute and Research Center, Lahore, PAK.

Abstract

Background Cancer patients are at increased risk of multi-organ failure due to either the primary disease burden or certain non-cancer-related risk factors. Among the most common complications is acute kidney injury (AKI), which is frequently seen in cancer settings. Among patients with cancer, the incidence of renal injury reaches up to 12.5%. However, critical care units have a much higher incidence, up to 50%. This study aimed to describe the characteristics of Asian populations with AKI with a background of malignancy, along with risk factors and outcomes. Materials and methods A retrospective tertiary-care single-center study was conducted in the intensive care unit (ICU). It included 182 cancer patients with AKI who were followed over a 36-month period. Results Our results revealed a mortality rate of 50.5% among cancer patients with AKI, with the highest mortality rate being among those with solid and hematologic malignancies. Common predisposing factors were sepsis (28%), dehydration (18.1%), and hypotension (9.9%). Several drugs were found to be among the most toxic agents, including vancomycin, colistin, nonsteroidal anti-inflammatory drugs, angiotensin receptor blockers, amphotericin, and certain chemotherapeutic drugs (especially cisplatin). A strong association was found between the length of ICU stay and mortality (p=<0.05), indicating a reduced survival rate with prolonged hospital stay even in critical care settings. Conclusion In summary, AKI in cancer patients increases their mortality due to a variety of risk factors. However, the early involvement of onconephrology and a multidisciplinary approach will result in better outcomes.

Keywords: acute kidney injury(aki)); diabetes mellitus; intensive care unit; kidney disease improving global outcomes (kdigo) classification; renal replacement therapy (rrt).