Abstract: SA-PO1247
Predictors of 28-Day Mortality in Critically Ill Patients with Cancer Requiring Hemodialysis for AKI
Session Information
- Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Cordova-Sanchez, Bertha M., Instituto Nacional de Cancerologia, Mexico City, CDMX, Mexico
- Bernardi Loor, Blas Ignacio, Instituto Nacional de Cancerologia, Mexico City, CDMX, Mexico
- Rosales Galvan, Jazziel Emmanuel, Universidad Nacional Autonoma de Mexico Facultad de Medicina, Mexico City, CDMX, Mexico
- Ñamendys- Silva, Silvio A., Instituto Nacional de Cancerologia, Mexico City, CDMX, Mexico
Background
Acute kidney injury (AKI) requiring renal replacement therapy in critically ill patients is associated with increased mortality. Previous prognostic models, were developed in incident chronic hemodialysis patients, and may not predict outcomes in critically ill cancer patients with dialysis requiring AKI. We aimed to identify factors independently associated with 28-day mortality and to evaluate the performance of existing prognostic scores.
Methods
We conducted a retrospective study including adult cancer patients admitted to the intensive care unit, who underwent intermittent hemodialysis for AKI management. Variables associated with 28-day mortality in bivariate analysis (p<0.05) were included in a multivariate logistic regression model. Collinearity and linearity of the logit for continuous variables, were verified. Model discrimination and calibration were assessed using area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow goodness of fit test, respectively. The performance of the final model was compared with SOFA, Cohen, and Couchoud scores.
Results
A total of 260 patients were included. We observed a 28-day mortality of 42.6%. In multivariate analysis, ECOG performance status, mechanical ventilation, non-renal SOFA score, and hemodynamic AKI were independently associated with mortality. The final model demonstrated good discrimination (AUC 0.816) and adequate calibration (Hosmer-Lemeshow p=0.613). SOFA score alone showed moderate discrimination (AUC 0.763) whereas Couchoud (AUC 0.638) and Cohen (AUC 0.579) showed limited predictive performance.
Conclusion
In critically ill cancer patients requiring hemodialysis for AKI, mortality was independently associated with functional status, severity of illness, mechanical ventilation, and non-obstructive AKI. The derived model outperformed prognostic scores developed for chronic incident hemodialysis.
Acknowledgment
None
28-day mortality predictors
| Variables | OR ( 95% CI) | p value | OR ( 95% CI) | p value |
| ECOG performance status | 1.70 (1.32-2.19) | <0.001 | 1.72 (1.30-2.30) | <0.001 |
| Mechanical ventilation | 4.80 (2.83-8.13) | <0.001 | 2.30 (1.19-4.46) | 0.013 |
| Non-renal SOFA score | 1.30 (1.20-1.41) | <0.001 | 1.19 (1.07-1.31) | <0.001 |
| Non- obstructive AKI | 5.16 (2.55-10.43) | <0.001 | 2.22 (0.99-4.98) | 0.052 |
ECOG Eastern Cooperative Oncology Group, SOFA Sequential Organ Failure Assessment, AKI acute kidney injury (non-obstructive refers to hemodynamic and intrinsic)