Background: One of the most serious complications among cancer
patients is Acute Kidney Injury (AKI). This study aimed to detect the
AKI incidence in cancer patients, to discover which clinical factors
could increase the risks of AKI, and to assess the effect of AKI on inhospital mortality, length of stay. Methods: This prospective cohort
study was conducted on 276 malignant patients (AKI: 40 cases and no
AKI: 236 cases). Serum creatinine, blood urea, complete blood count,
uric acid, Electrolyte'' potassium, sodium, calcium'', urine analysis with
comment on RBCs cast, liver function test'' ALT, AST, Albumin and
bilirubin'' were measured every three weeks, and urine albumin
creatinine ratio was done before chemotherapy and after finishing
treatment. Results: pre-existing comorbidities including hypertension
(HTN), diabetes (DM), and coronary heart disease are significant
predictors for increased risk of AKI in cancer patients. Patients with
hyponatremia, hypokalemia and hyperuricemia shared a significantly
higher risk of AKI (a OR = 2.95, 2.49, and 3.01). Cox regression
analysis revealed that HTN and DM also increased the mortality risk
when adjusting demographic and clinical features. The mean survival
rate was significantly lower in group with AKI compared to group
without AKI (16.331 versus 19.589). AKI stage II and III had longer
median length of hospital stay compared to stage I. (In our studied
patient, there is high admission rate of patient with cancer to intensive care units, and most of
critically ill patients with cancer are susceptible to AKI and the incidence of requiring kidney
Replacement Therapy. The most common risk factors that developed with cancer patient was
septic shock, exposure to nephrotoxins as "chemotherapy", severe dehydration due to associated
vomiting and GIT upset, and others All of this risk factor are precipitating factor for AKI.
Incidence of AKI itself will cause high mortality rate among cancer patient in compared with ill
patient without cancer, and also the need for Renal Replacement Therapy entails high mortality
rate. So, according to our results, we find mean survival rate in cancer patient with AKI is lower
than that in patient without AKI.) Conclusion: The in-hospital mortality was 5% in cancer
patients with AKI. The severe AKI was associated with poor clinical outcome, long hospital stays
and high daily costs. Pre-existing comorbidities and electrolyte disturbances are the predicting
factors for AKI incidence. |
