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Kidney Week

Abstract: PO2180

In-Hospital and 1-Year Mortality Among Patients with AKI and Haematological Malignancies

Session Information

  • Onco-Nephrology - 1
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Coelho, Inês Dionisio, Hospital Amato Lusitano, Castelo Branco, Castelo Branco, Portugal
  • Chuva, Teresa, Instituto Portugues de Oncologia do Porto Francisco Gentil EPE, Porto, Porto, Portugal
  • Ferreira, Hugo, Instituto Portugues de Oncologia do Porto Francisco Gentil EPE, Porto, Porto, Portugal
  • Paiva, Ana Maria, Instituto Portugues de Oncologia do Porto Francisco Gentil EPE, Porto, Porto, Portugal
  • Costa, José Maximino, Instituto Portugues de Oncologia do Porto Francisco Gentil EPE, Porto, Porto, Portugal
Background

Patients with haematological malignancies (HM) are at high risk for acute kidney injury (AKI), which is associated with high morbidity and mortality. The aim of this study was to identify the prognostic factors for in-hospital mortality and one-year mortality in this population.

Methods

We conducted a single centre, retrospective, observational cohort study of 101 in-hospital patients with AKI and HM between 1 January 2015 and 31 December 2019. We recorded essential demographic, clinical and laboratory data at baseline, 1 and 12 months. We classified AKI according to the KDIGO definition. Cox proportional hazard model was applied to investigate the one-year mortality, and logistic regression analysis was used to assess the in-hospital mortality.

Results

The study population included 64 males and 37 females, with a mean age of 58.7 ± 16.8 years. Multiple myeloma was present in 30.7% (n=31) of the patients, followed by non-Hodgkin lymphoma (LNH) in 27,7% (n=28). 51,5% (n=52) were admitted to intensive care unit (ICU). 60,4% (n=61) needed renal support therapy (RST). Basal GFR, one-month GFR and one-year GFR were, respectively, 65.7 ± 28.9 mL/min/1.73m2, 57.1 ± 28.5 mL/min/1.73m2 and 54.9 ± 28.1 mL/min/1.73m2. Mean length of in-hospital stay was 18 days (IQR 1-88). In-hospital death was 52.5% and after one year only 26 patients were alive. In multivariate analysis, the independent predictors for in-hospital mortality were invasive mechanical ventilation (IMV) (OR 49.53; 95% CI:9.17 – 267.57; p<0.001) and sepsis (OR 5.09; 95% CI:1.18 – 21.89; p=0.029). The C-statistic was 0.93 (95% CI: 0.87 – 0.98), indicating that the equation had a great discriminatory power. The independent predictors for one-year mortality were LNH (HR 2.78; 95% CI:1.53 – 5.05; p=0.001), cancer progression (HR 2.91; 95% CI:1.56 – 5.41; p=0.001) and IMV (HR 5.79; 95% CI:3.30 – 10.15; p<0.001.). Elevated levels of albumin at the time of AKI conferred a better prognosis (HR 0.63; 95% CI:0.42 – 0.95; p=0.027).

Conclusion

Our model showed that HM patients with AKI are at high risk of sepsis and IMV, resulting in elevated in-hospital death. Elevated levels of albumin at the time of AKI correlated with a better one-year survival, while LNH, cancer progression and IMV were risk factors for death.