A cross-sectional study of chemotherapy-related AKI.

Abstract

PURPOSE:

This study aims to detail the characteristics of chemotherapy-related acute kidney injury (CR-AKI) and investigate its effect on patient outcomes.

METHODS:

This is a multicenter cross-sectional study of cancer patients with CR-AKI screened from hospital-acquired adult AKI patients based on a nationwide AKI survey in China.

RESULTS:

Of the 3468 patients with hospital-acquired AKI, 258 cases of CR-AKI were identified. Of the patients, 20.1% (52/258) were ≥ 70 years old. Among the 258 CR-AKI cases, 61 (23.6%) reached AKI stage 3, and 75 (29.1%) reached AKI stage 2. The remaining 122 (47.3%) remained at AKI stage 1. A total of 413 chemotherapeutic agents were related to AKI, of which platinum compounds (24.5%, 101/413) were the most common. In-hospital mortality was 14.7% (38/258), and the rate of AKI non-recovery was 48.3% (100/207). AKI stage 3 (OR 2.930, 95% CI 1.156-7.427) and age ≥ 70 years (OR 3.138, 95% CI 1.309-7.519) were independent risk factors for in-hospital death. Compared to stage 2 or 3 AKI cases, a higher proportion of patients with stage 1 AKI did not recover their renal function (57.1% vs. 41.4% vs. 36.4%, P = 0.032). More AKI episodes were not recognized in patients with stage 1 AKI compared with the other two groups (82.8% vs. 60.0% vs. 36.1%, P < 0.001).

CONCLUSIONS:

CR-AKI accounted for a noteworthy proportion of hospital-acquired AKI, and severe CR-AKI increased in-hospital mortality. Mild CR-AKI was more likely to be overlooked, and sustained kidney injury was common in this situation. Recognizing CR-AKI at an early stage and personalizing treatment should be emphasized in those undergoing chemotherapy.

• Authors: Xin Kang, Xizi Zheng, Damin Xu, Tao Su, Ying Zhou, Jing Ji, Qi Yu, Yimin Cui, Li Yang
• Journal: European journal of clinical pharmacology (Eur J Clin Pharmacol) Vol. 77 Issue 10 Pg. 1503-1512 (Oct 2021) ISSN: 1432-1041 [Electronic] Germany
• PMID: 33993344 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Antineoplastic Agents

Topics

• Acute Kidney Injury (chemically induced, mortality)
• Adult
• Age Factors
• Aged
• Antineoplastic Agents (adverse effects)
• Comorbidity
• Cross-Sectional Studies
• Female
• Hospital Mortality
• Humans
• Iatrogenic Disease
• Male
• Middle Aged
• Patient Acuity