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Kidney Week

Abstract: TH-PO091

Clinical Significance of AKI in Lung Cancer Patients

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Cho, Semin, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Kang, Eunjeong, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Joo, Kwon Wook, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea (the Republic of)
Background

Acute kidney injury (AKI) in cancer patients is related to increased morbidity and mortality. Previous our exploration of AKI in cancer patients showed unexpectedly a higher incidence of AKI in lung cancer patients than those with other malignancy. This study aimed to evaluate the clinical significance of AKI in lung cancer patients.

Methods

The patients diagnosed as lung cancer from 2004 to 2013 in Seoul National University Hospital were enrolled. They were categorized into two groups by an occurrence of AKI, and the patients with AKI were categorized into three groups by AKI stage. AKI was defined according to KDIGO-AKI guideline. Demographic factors, co-morbidities, laboratory findings, count of contrast-enhanced computed tomography (CE-CT), pathologic types, and treatment options such as surgery and chemotherapy were included as covariates. We performed Cox proportional hazard modeling for mortality among patients who survived more than 1 year after cancer diagnosis.

Results

A total of 3,202 patients were included in the final analysis. Mean age was 63.8±10.34 years and 68.6% were male. AKI occurred in 1,783 (55.7%) patients during the follow-up period. Most AKI was mild AKI with stage 1 (75.8%). We found that the development of AKI were independently associated with older age, higher systolic blood pressure, diabetes mellitus, high initial serum creatinine, anemia, hyperkalemia, hypophosphatemia, hyperuricemia, hypoalbuminemia, acidosis, frequent CE-CT, and chemotherapy. During follow-up duration (2.64±2.18 years), 21 (0.7%) patients reached end-stage kidney failure and all of them were experienced AKI. In the survival analysis, we found that not only AKI development but also AKI severity was an independent risk factors for mortality even after adjustment with cancer-specific variables including stage or pathologic type.

Conclusion

In this study, more than half of lung cancer patients experienced AKI during their diagnosis and treatment period. Moreover, AKI occurrence and more advanced AKI were associated with higher mortality risk. Further studies about risk factor analysis for AKI occurrence should be needed to prevent AKI in lung cancer patients.