Kidney Week

Abstract: SA-PO003

Epidemiology of AKI in Cancer Patients

Session Information

• AKI Clinical: Epidemiology and Outcomes
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Acute Kidney Injury

• 003 AKI: Clinical and Translational

Authors

• Jung, Young Lee, Seoul National University Hospital, Seoul, Korea (the Republic of)

Young Lee Jung,

• Kang, Eunjeong, Seoul National University Hospital, Seoul, Korea (the Republic of)

Eunjeong Kang,

• Park, Minsu, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Minsu Park,

• Park, Namyong, Seoul National University College of Engineering, Seoul , Korea (the Republic of)

Namyong Park,

• Lee, Hajeong, Seoul National University Hospital, Seoul, Korea (the Republic of)

Hajeong Lee,

Background

Acute kidney injury (AKI) is common in patients with cancer because of malignancy itself, treatment regimen, contrast exposure and coexisting morbidities. However, epidemiologic data for AKI in cancer patients are still lacking.

Methods

We retrospectively assembled newly diagnosed cancer patients at Seoul National University Hospital between January 2004 and December 2013. Among a total of 106,004 cancer patients, we excluded patients with dual primary cancer, age under 18 years-old, advanced renal dysfunction with eGFR less than 15 ml/min/1.73m². Patients who could not define AKI due to lack of data were also excluded. AKI was defined as the KDIGO guideline. We categorized patients according to involved organs. We collected demographic information, comorbidities such as diabetes and hypertension, laboratory tests, contrast exposures represented by CT count, and treatment regimen including surgery and chemotherapeutic agents use. AKI incidence was showed as incidence rate estimated by the person-years at risk.

Results

After exclusion, we finally included 68,036 patients. Among them, 23,024 (33.8%) patients developed AKI after cancer diagnosis. More than half of AKI patients experienced recurrent AKI events and 15.9% went through more than 5 times of AKI events. Interestingly, AKI in cancer patients tend to be increasing over time continuously. When compared AKI incidence rate according to cancer type, respiratory tract cancer revealed the highest incidence rate (289.5 cases/1,000 person-year), followed by genitourinary tract cancer (260.8 cases/1,000 person-year) and hematologic malignancies (217.1 cases/1,000 person-year). Patients with AKI experience were older, more men, and had more coexisting diseases such as diabetes and hypertension. They had lower initial renal function, lower serum albumin, and serum hemoglobin. In addition, they exposure more frequent contrast CT scan and chemotherapeutic agents.

Conclusion

In this study, we find that AKI events are increasing, and develop quite frequently and repetitively. Notably, respiratory tract cancer is proved to be the highest risk of AKI incidence. Not only demographic and co-existing factors but also treatment related factors may contribute to the AKI development.