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Kidney Week

Abstract: TH-PO072

Temporal Trends and Impact on Mortality of AKI in Cancer Patients

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Jung, Young Lee, Seoul National unioversity Hospital, Bucheon, Korea (the Republic of)
  • Park, Minsu, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Kang, Eunjeong, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Joo, Kwon Wook, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
Background

Recently, overall death rate in cancer patients has been improved in virtue of advanced preventive and treatment modalities. Acute kidney injury (AKI) is one of serious complication associated with worse outcomes, although its temporal trend and impact on outcome remain unclear in cancer patients.

Methods

This study retrospectively assembled newly diagnosed cancer patients at Seoul National University Hospital between January 2005 and December 2013. Among a total of 98,284 incident cases of cancer, we excluded patients with multiple primary cancer, age under 18 years-old, advanced renal dysfunction with eGFR less than 15 ml/min/1.73m2. We evaluated annual trends of AKI occurrence within the first year after diagnosis of cancer.

Results

We finally included 68,302 patients after exclusion, and 14,152 (23.4%) patients in them developed AKI within the first year after cancer diagnosis. Overall incidence of AKI was highest in lung cancer (289.5 /1000 person-year), followed by genitourinary tract cancer (260.8/1000 person-year) and hematologic malignancies (217.1 /1000 person-year). As times go by, cancer patients has been older, more hypertensive and more diabetic, and exposed more radiocontrast. With this trend, annual AKI development has increased from 21.0% to 27.8% (P for trend <0.001). On the contrary, 5-year mortality has decreased from 42.9% to 26.5% (P for trend <0.001). Multivariate analysis showed adjusted odd ratio of AKI on mortality has been increasing continuously.

Conclusion

Although overall death rate has decreased, AKI incidence and the impact of AKI on mortality have been increasing over time in cancer patients. Our study suggested that appropriate preventive strategy and adequate management for AKI in patients with malignancy, which is an important role of nephrologists.

Figure 1. Temporal trends of AKI incidence and Impact on Mortality from 2005 to 2013.