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Kidney Week

Abstract: PO1919

Review of Onconephrology Cases: An Insight from the Middle East

Session Information

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Madhyastha, Rakesh, Cleveland Clinic Abu Dhabi, Abu Dhabi, Abu Dhabi, United Arab Emirates
  • Gupta, Sudeendra S., Cleveland Clinic Abu Dhabi, Abu Dhabi, Abu Dhabi, United Arab Emirates
  • Ghosn, Muriel, Cleveland Clinic Abu Dhabi, Abu Dhabi, Abu Dhabi, United Arab Emirates
  • Hijazi, Fadi A., Cleveland Clinic Abu Dhabi, Abu Dhabi, Abu Dhabi, United Arab Emirates
  • Attallah, Nizar M., Cleveland Clinic Abu Dhabi, Abu Dhabi, Abu Dhabi, United Arab Emirates

Group or Team Name

  • Department of Nephrology, Cleveland Clinic Abu dhabi
Background

Onconephrology is a new subspecialty of nephrology and its data was sparse from the middle east. We have collected data of cancer patients admitted to a tertiary care center and referred to the department of Nephrology to recognize the most common preventable causes of AKI and their outcome in this patient population

Methods

We conducted a retrospective observational study of 39 admitted cancer patients referred to the department of Nephrology between November 2020 and March 2021.

Results

In our study 69% were males,31% were females. Tumors were;prostate cancer(n=6),bladder cancer (n=5), RCC (n=5),HCC(n=4)and Colon cancer (n=3),breast cancer (n=3),unknown primary (n=2), (n=1) were SCC ,tongue,ovary,thyroid,endometrial cancerand laryngeal cancer,additioanlly B cell lymphoma (n=1)and multiple myeloma (n=4).Background history of CKD was present in, 38% (n=15) of the cohort.CKD stage 3 was the most prevalent (n=10). 1 patient had ESRD and maintained on dialysis and 2 patients had undergone a kidney transplant.Recurrent AKIs were most common (n=6), followed by nephrectomy (n=4) and hypertension (n=4), other included diabetes mellitus, urinary tract obstruction, atrophic kidneys, and multiple myeloma.Causes of AKI were Sepsis 30%,hypovolemia 12%,urinary tract infection 10.2%, drug-induced AKI 10% & Hypercalcemia 7.6%.Less common causes were hemorrhagic shock and IV iodinated contrast exposure.Only 33% of the study population was actively receiving oncotherapy at the time of admission. Amongst the cohort, 48% were oliguric and the rest were non-oliguric. A total of 16 patients, received renal replacement therapy during admission; CRRT was done in 10/16 patients, 5/16 patients received conventional hemodialysis and 1 patient received both modalities. Amongst the patients requiring CRRT, the survival rate was 21%, and for patients who received hemodialysis, the survival rate was 50%.41% of the patients died during the admission; 62% of the deaths were deemed secondary to underlying cancer and the remaining 38% were attributed to other causes; the most common being sepsis.

Conclusion

Our study reiterates the importance of prevention of AKI by early recognition and prompt management of risk factors. This study prompts the need for quality improvement initiatives aiming at improving the outcomes of such patients at all tertiary care centers