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Kidney Week

Abstract: PO2207

Snapshot of AKI Profile in Patients in Oncology Settings: A Single-Center Experience

Session Information

  • Onco-Nephrology - 2
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Kumthekar, Girish Vasudeo, Basavatarakam Indo-American Cancer Institute and Research Centre, Hyderabad, Telangana, India
  • Koppula, Praveen kumar, Basavatarakam Indo-American Cancer Institute and Research Centre, Hyderabad, Telangana, India
  • Madarasu, Rajasekara Chakravarthi, RENOWN Clinical Services, Hyderabad, Telangana, India

Group or Team Name

  • RENOWN Clinical Services, Hyderabad, Telangana,INDIA.
Introduction

Acute kidney injury (AKI) may result from the cancer itself, treatment of cancer or associated complications. In cancer patients with AKI complete recovery of renal function was seen in 82% and chronic dialysis was needed in 6% of patients. Overall severity of illness, age, and functional status have more of an impact on prognosis than underlying malignancy, and the presence of cancer may not be an absolute exclusion criterion for withholding RRT. Hospital mortality approaches 80% in cancer patients with AKI.Cancer associated AKI (CA-AKI) is very prevalent with reported incidence of 12% to 49%. We tried to look into incidence, etiology and outcome of AKI in a tertiary care cancer hospital.

Case Description

For two consecutive months all patients admitted in ICU at Basavatarakam Indo-American Cancer Hospital were observed for development of AKI with KGIDO criterion. We found 45 patients who developed AKI out of 83 total ICU admissions (54.21%). Chronic kidney disease was present in 17 patients (37.77%), diabetic kidney disease being the commonest (64.70%). The commonest etiology of AKI was sepsis (77.8%) and septic shock was present in majority of these patients (66.7%). Other causes of AKI were hypercalcemia (4.4%), chemotherapy associated (44.4%), obstructive nephropathy (8.9%). Metabolic acidosis was predominant finding (75.6%) with oliguria being least common (26%). Hematological malignancies were frequently associated with AKI (33.3%) followed by gastrointestinal tract tumors (24.44%). Urological malignancies were least associated with AKI (6.6%). Large number of patients required renal replacement therapy (RRT) (48.9%). SLED was commonest modality (n=15; 68.18%) of RRT followed by CRRT/CVVHDF (N=8; 34.78%). Regional citrate anticoagulation was commonest anticoagulation used (62.5%). 46% patients recovered their renal functions but creatinine did not reach baseline for 11% of patients. 29% patients with AKI died and a 14% of patients lost to follow up.CRRT was associated with better survival (n=4; 50%) followed by SLED (n=4; 26.66%).

Discussion

Incidence of AKI was higher among patients in oncological ICU with half of them required RRT. Commonest etiology of AKI was sepsis where shock state was observed in majority of patients. Although SLED was used more frequently, outcomes were better with CRRT/CVVHDF.