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Multicenter Study
. 2021 Oct;77(10):1503-1512.
doi: 10.1007/s00228-021-03115-y. Epub 2021 May 15.

A cross-sectional study of chemotherapy-related AKI

Xin Kang  1 , Xizi Zheng  1 , Damin Xu  1 , Tao Su  1 , Ying Zhou  2 , Jing Ji  1 , Qi Yu  1 , Yimin Cui  2 , Li Yang  3
Affiliations
Multicenter Study

A cross-sectional study of chemotherapy-related AKI

Xin Kang et al. Eur J Clin Pharmacol. 2021 Oct.

Abstract

Purpose: This study aims to detail the characteristics of chemotherapy-related acute kidney injury (CR-AKI) and investigate its effect on patient outcomes.

Methods: This is a multicenter cross-sectional study of cancer patients with CR-AKI screened from hospital-acquired adult AKI patients based on a nationwide AKI survey in China.

Results: Of the 3468 patients with hospital-acquired AKI, 258 cases of CR-AKI were identified. Of the patients, 20.1% (52/258) were ≥ 70 years old. Among the 258 CR-AKI cases, 61 (23.6%) reached AKI stage 3, and 75 (29.1%) reached AKI stage 2. The remaining 122 (47.3%) remained at AKI stage 1. A total of 413 chemotherapeutic agents were related to AKI, of which platinum compounds (24.5%, 101/413) were the most common. In-hospital mortality was 14.7% (38/258), and the rate of AKI non-recovery was 48.3% (100/207). AKI stage 3 (OR 2.930, 95% CI 1.156-7.427) and age ≥ 70 years (OR 3.138, 95% CI 1.309-7.519) were independent risk factors for in-hospital death. Compared to stage 2 or 3 AKI cases, a higher proportion of patients with stage 1 AKI did not recover their renal function (57.1% vs. 41.4% vs. 36.4%, P = 0.032). More AKI episodes were not recognized in patients with stage 1 AKI compared with the other two groups (82.8% vs. 60.0% vs. 36.1%, P < 0.001).

Conclusions: CR-AKI accounted for a noteworthy proportion of hospital-acquired AKI, and severe CR-AKI increased in-hospital mortality. Mild CR-AKI was more likely to be overlooked, and sustained kidney injury was common in this situation. Recognizing CR-AKI at an early stage and personalizing treatment should be emphasized in those undergoing chemotherapy.

Keywords: AKI recovery; AKI stage; Chemotherapy-related AKI; In-hospital death.

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