Acute Kidney Injury in Cancer Patients

2018 ◽  
pp. 137-148 ◽  
Author(s):  
Maurizio Gallieni ◽  
Laura Cosmai ◽  
Camillo Porta
Keyword(s):  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Kidney Injury

KIDNEY INJURY IN CANCER THERAPY

2018 ◽  
Vol 22 (5) ◽  
pp. 17-24 ◽  
Author(s):  
E. V. Burnasheva ◽  
Y. V. Shatokhin ◽  
I. V. Snezhko ◽  
A. A. Matsuga
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Cytotoxic Effect ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Chemotherapeutic Agents ◽  
Oxygen Intermediates ◽  
Circulating Blood Volume

Кidney injury is a frequent and significant complication of cancer and cancer therapy. The kidneys are susceptible to injury from malignant infiltration, damage by metabolites of malignant cells, glomerular  injury, nephrotoxic drugs including chemotherapeutic agents. Also  bone marrow transplantation complications, infections with immune  suppression (including septicemia), tumor lysis syndrome should be  taken into account. Chemotherapeutic agents are a common cause  of acute kidney injury but can potentially lead to chronic kidney  disease development in cancer patients. This article summarizes risk  factors of acute kidney injury in cancer patients. Risk factors are  divided into two groups. The systemic are decrease of total  circulating blood volume, infiltration of kidney tissue by tumor cells,  dysproteinemia, electrolyte disturbances. The local (renal) risk  factors are microcirculation disturbances, drugs biotransformation  with formation of reactive oxygen intermediates, high concentration of nephrotoxic agents in proximal tubules and its  sensitivity to ischemia. Drug-related risk factors include: drugs  combination with cytotoxic effect high doses long term use necessity, direct cytotoxic effect of not only chemotherapeutic agents but also its metabolites, mean solubility forming intratubular  precipitates. Early diagnosis, timely prevention and treatment of  these complications provide significantly improve nononcologic results of treatment.

scholarly journals Epidemiology and outcomes of acute kidney injury in hospitalized cancer patients in China

2019 ◽  
Vol 144 (11) ◽  
pp. 2644-2650 ◽  
Author(s):  
Yichun Cheng ◽  
Sheng Nie ◽  
Lu Li ◽  
Yanqin Li ◽  
Diankun Liu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Kidney Injury

scholarly journals Two acute kidney injury risk scores for critically ill cancer patients undergoing non-cardiac surgery

2012 ◽  
Vol 3 (4) ◽  
pp. 278 ◽  
Author(s):  
Xue-zhong Xing ◽  
Hai-jun Wang ◽  
Chu-lin Huang ◽  
Quan-hui Yang ◽  
Shi-ning Qu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Cancer Patients ◽  
Critically Ill ◽  
Injury Risk ◽  
Kidney Injury ◽  
Risk Scores

Acute kidney injury and major outcomes in cancer patients with no history of chronic kidney disease (CKD) with coronavirus 2019 (COVID-19) infection.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18816-e18816
Author(s):  
Cesar Simbaqueba ◽  
Omar Mamlouk ◽  
Kodwo Dickson ◽  
Josiah Halm ◽  
Sreedhar Mandayam ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Kidney Injury ◽  
Hazard Model ◽  
Cancer Center ◽  
Icu Admission ◽  
Significant Difference ◽  
History Of

e18816 Background: Acute Kidney Injury (AKI) in patients with COVID-19 infection is associated with poor clinical outcomes. We examined outcomes (hemodialysis, mechanical ventilation, ICU admission and death) in cancer patients with normal estimated glomerular filtration rate (eGFR) treated in a tertiary referral center with COVID-19 infection, who developed AKI within 30 days of diagnosis. Methods: All patient data — demographics, labs, comorbidities and outcomes — were aggregated and analyzed in the Syntropy platform, Palantir Foundry (“Foundry”), as part of the Data-Driven Determinants of COVID-19 Oncology Discovery Effort (D3CODE) protocol at MD Anderson. The cohort was defined by the following: (1) positive COVID-19 test; (2) baseline eGFR >60 ml/min/1.73m2most temporally proximal lab results within 30 days prior to the patient’s infection. AKI was defined by an absolute change of creatinine ≥0.3 within 30 days after the positive COVID-19 test. Kaplan-Meier analysis was used for survival estimates at specific time periods and multivariate Cox Proportional cause-specific Hazard model regression to determine hazard ratios with 95% confidence intervals for major outcomes. Results: 635 patients with Covid-19 infection had a baseline eGFR >60 ml/min/1.73m2. Of these patients, 124 (19.5%) developed AKI. Patients with AKI were older, mean age of 61+/-13.2 vs 56.9+/- 14.3 years (p=0.002) and more Hypertensive (69.4% vs 56.4%, p=0.011). AKI patients were more likely to have pneumonia (63.7% vs 37%, p<0.001), cardiac arrhythmias (39.5% vs 20.7%, p<0.001) and myocardial infarction (15.3% vs 8.8%, p=0.046). These patients had more hematologic malignancies (35.1% vs 19%, p=0.005), with no difference between non metastatic vs metastatic disease (p=0.284). There was no significant difference in other comorbidities including smoking, diabetes, hypothyroidism and liver disease. AKI patients were more likely to require dialysis (2.4% vs 0.2%, p=0.025), mechanical ventilation (16.1% vs 1.8%, p<0.001), ICU admission (43.5% vs 11.5%, p<0.001) within 30 days, and had a higher mortality at 90 days of admission (20.2% vs 3.7%, p<0.001). Multivariate Cox Proportional cause-specific Hazard model regression analysis identified history of Diabetes Mellitus (HR 10.8, CI 2.42 - 48.4, p=0.001) as an independent risk factor associated with worse outcomes. Mortality was higher in patients with COVID-19 infection that developed AKI compared with those who did not developed AKI (survival estimate 150 days vs 240 days, p=0.0076). Conclusions: In cancer patients treated at a tertiary cancer center with COVID-19 infection and no history of CKD, the presence of AKI is associated with worse outcomes including higher 90 day mortality, ICU stay and mechanical ventilation. Older age and hypertension are major risk factors, where being diabetic was associated with worse clinical outcomes.

Acute kidney injury in the cancer patient

2015 ◽  
Author(s):  
Gilbert W. Moeckel ◽  
Veena Manjunath ◽  
Mark A. Perazella
Keyword(s):  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Clinical Presentation ◽  
Kidney Tissue ◽  
Hospital Setting ◽  
Kidney Injury ◽  
Direct Effects ◽  
Significant Morbidity ◽  
Adequate Treatment ◽  
Kidney Lesions

Acute kidney injury in cancer patients is a complicated clinical condition associated with significant morbidity and mortality, especially in the hospital setting. Cancer patients may develop a variety of different kidney lesions that impair not only immediate survival but also limit the adequate treatment of the underlying malignant process. This poses a significant challenge for clinicians.The mechanisms that lead to acute kidney injury in cancer patients are similar to those seen in non-cancer patients. Moreover, significant morbidity is seen in association with chemotherapy, as well as through direct effects of the cancer on the kidney (i.e. obstruction, infiltrate).This chapter reviews the clinical presentation of the most common malignancies that affect the kidney, discusses their pathologic manifestations in kidney tissue, and reviews options for the clinical management of cancer patients with acute kidney injury.

scholarly journals Acute kidney injury in cancer patients: A nationwide survey in China

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Juan Jin ◽  
Yafang Wang ◽  
Quanquan Shen ◽  
Jianguang Gong ◽  
Li Zhao ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Kidney Injury ◽  
Nationwide Survey

Incidence of acute kidney injury in cancer patients: A Danish population-based cohort study

2011 ◽  
Vol 22 (4) ◽  
pp. 399-406 ◽  
Author(s):  
Christian Fynbo Christiansen ◽  
Martin Berg Johansen ◽  
Wendy J. Langeberg ◽  
Jon P. Fryzek ◽  
Henrik Toft Sørensen
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Cancer Patients ◽  
Kidney Injury ◽  
Population Based ◽  
Danish Population

scholarly journals Prognostic factors for acute kidney injury development in critically ill cancer patients

Critical Care ◽  
2011 ◽  
Vol 15 (S2) ◽  
Author(s):  
LA Hajjar ◽  
H Palomba ◽  
J Almeida ◽  
J Fukushima ◽  
RE Nakamura ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Critically Ill ◽  
Kidney Injury ◽  
Acute Kidney Injury Development

scholarly journals Comparison of equations to estimate glomerular filtration rate and their impact on frequency of cisplatin-associated acute kidney injury

Kidney360 ◽  
2020 ◽  
pp. 10.34067/KID.0000572020
Author(s):  
Shveta S. Motwani ◽  
Toni K. Choueiri ◽  
Ann H. Partridge ◽  
Jiani Hu ◽  
Marina D. Kaymakcalan ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cancer Patients ◽  
Predictive Value ◽  
Filtration Rate ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Correlation Coefficients ◽  
Accurate Estimation

Background: Accurate estimation of kidney function is essential for patient selection and drug dosing in cancer patients. Glomerular filtration rate (GFR) estimating equations are necessary for decision-making and monitoring. Our aim was to identify which of these equations-estimated creatinine clearance (eCrCl) by Cockcroft-Gault (CG), estimated GFR (eGFR) by Modification of Diet in Renal Disease (eGFRMDRD), Chronic Kidney Disease Epidemiology Collaboration (eGFRCKD-EPI) or recently proposed Janowitz-Williams equation (eGFRJ-W)-would be most suitable for GFR estimation among patients with cancer receiving cisplatin. Methods: We assembled a cohort of 5274 cancer patients treated with cisplatin-based chemotherapy at two large cancer centers. We ascertained the frequency of cisplatin-associated acute kidney injury (C-AKI) defined as a ≥0.3mg/dl rise in serum creatinine over baseline. We compared baseline eGFR and eCrCl using Bland-Altman (B-A) plots, coefficients of variation (CV), and concordance correlation coefficients. We calculated positive predictive value (PPV), negative predictive value (PPV), accuracy, and area under the curve (AUC). Results: Patients were predominantly middle-aged (58, IQR 49-66 years), overweight (BMI 26.2, IQR 23.1-29.8 kg/m2), and white (87.6%) with a median baseline creatinine of 0.8 mg/dl and median cisplatin dose of 99 mg. C-AKI developed in 11.5% of the cohort. eGFRCKD-EPI had the highest PPV as well as AUC. eGFRCKD-EPI and eGFRMDRD along with their BSA-modified counterparts had the closest agreement with the lowest CV (7.2, 95% CI 7.0-7.3) and the highest concordance. C-AKI was lowest when using eGFRCKD-EPI to define eGFR ≥60ml/min/1.73 m2. Conclusion: Based on its superior diagnostic performance, eGFRCKD-EPI should be used to estimate GFR in patients being considered for cisplatin-based chemotherapy.

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