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Table 1 Summary of publications between 2010 and 2015 on critically ill cancer patients with AKI

From: Acute kidney injury in critically ill cancer patients: an update

Reference

Multicenter (Yes/No)

Type of cancer

Population

Reasons for admission to ICU

Definition of AKI

Incidence of AKI

Cause(s) of AKI/contributing factors

Survival/mortality of AKI cancer patients (%)

Survival/mortality of non-AKI cancer patients (%)

Indications for RRT

RRT modality

Long-term prognosis for AKI patients

[46]

No

Hemato

537 with induction chemo

-

50 % rise in SCr above baseline

RIFLE

36 %

RIFLE

R: 15 %

I: 10 %

F: 11 %

?

Mortality

RIFLE

R: 13.6 %

I: 19.6 %

F: 61.7 %

Mortality: 4 %

Indications?

RRT: 8 %

?

 

[48]

No

Hemato

344

Infections/noninfectious complications

?

16.6 %

?

?

?

?

  

[47]

No

Hemato

94

Severe sepsis/shock: 71 %

Renal failure: 17 %

Respiratory failure: 12 %

Need for RRT

RIFLE

RIFLE

R:7 %

I: 33 %

F: 60 %

Septic AKI: 54 %

Nonseptic AKI: 46 %

Nephrotoxic drugs: 15/94

Hypovolemic: 13/94

TLS: 11/94

23.5 % survival

-

 

CVVHDF/CVVHF

23 % of survivors persistent AKI after ICU discharge

[32]

No

All

3795

medical/surgical pts

Oncology ICU

Not specified

Assess link to outcome of increases of SCr cfr RIFLE

21.8 %

RIFLE

R: 12.5 %

I: 4.9 %

F: 4.5 %

Multiple

Creat rise: 10 %:

Mortality: 15–25 %;

Creat rise 25 %:

?

?

RRT: 19 % in nonsurvivors, 1.6 % in survivors

?

?

Mortality: 14–30 %

Rise in SCr of 25 % (≥48 h)

Mortality: 36 %

No rise in SCr of 25 % for ≥ 48 h:

Mortality: 15 %

[40]

Yes

All

All AKI 773 pts

Ca pts: 118 (15.2 %)

Solid cancer: 73 %

Hemato: 27 %

Serious comorbidities

RIFLE before start of RRT

118/773

100 % AKI

RIFLE

R: 25 %

I: 24 %

F: 52 %

Sepsis: 78 %

Ischemia/shock: 74 %

Toxins/contrast: 32 %

Ca pts hospital survival: 12 % of all survivors

Non Ca pts hospital survival: 7 % of all survivors

Overall survival: 30 %

-

Azotemia: 58 %

Fluid overload: 55 %

Acidosis: 48 %

CRRT: 89 %

?

[45]

No

Hemato

199 pts onco

Oncology ICU

Respiratory failure: 33 %

Postoperative: 20 %

Sepsis: 21.1 %

?

Need for RRT?

8 % on ICU admission

?

RRT survivors: 38 %

RRT nonsurvivors: 62 %

?

79 (40.9 %)

?

?

[44]

No

All

477 ca pts

ICU surgical pts

AKIN criteria

10.3 % on ICU admission

Post surgery

Hospital mortality: 13 %

ICU mortality: 10.9 %

Hosp mortality: 1.5 %

ICU mortality: 1 %

?

?

?

[6]

No

All

563 ca pts with sepsis

Solid cancer: 77 %

Hemato: 23 %

Sepsis

?

Need for RRT?

20 % on RRT

Sepsis

?

Overall mortality:

ICU: 51 %

Hospital: 65 %

6 month: 72 %

?

?

?

?

[11]

No

Hemato

200 pts

Start chemo

1 day before ICU

See [73]

RIFLE

Total:68.5 %

RIFLE

R: 27 %

I: 19.7 %

F: 53.3 %

Prerenal: 48.2 %

TLS: 43.8 %

ATN: 28.5 %

Nephrotoxicity: 20.4 %

Multiple causes: 45.3 %

ICU mortality: 35 %

Hospital mortality: 35 %

ICU mortality: 7.9 %

Hospital mortality: 19.1 %

?

52.7 % RRT

(during ICU)

IHD: 63.8 %

CRRT: 19.4 %

Both: 16.6 %

Complete hemato remission

At 6 months

AKI: 39.4 %

Non AKI: 68.3 %

[42]

No

All

162 ca pts

Solid cancer: 104

Hemato: 35.8 %

Septic shock: 66.7 %

Respiratory failure: 63.6 %

?

Need for RRT?

AKI: 30 %

Hemato: 41 %

Solid cancer: 23 %

?

Mortality

AKI:26 %

 

Total RRT: 33 %

Hemato: 38 %

Solid cancer: 30 %

?

?

[43]

No

All

56 pts with chemo

Chemo

?

16 %

Hospital nonsurvivors: 13 %

Hospital survivors: 18 %

?

?

 

39 %

CVVHF

?

[33]

Yes

All

Hemato: 1741

Solid tumors: 602

Not specified

?

Hemato: 20 %

Solid cancer: 11 %

?

?

?

   

[30]

Yes

All

Ca pts: 357

(19.8 % of all admissions)

AKI-EPI study

Multiple

KDIGO

59 %

?

?

?

?

?

?

[41]

Yes

Hemato

Neutropenic pts: 289

Sepsis: 80 %

Acute respiratory failure: 64 %

Shock: 58 %

?

Need for RRT?

18 %

?

19.85 % mortality

?

?

?

?

[39]

Yes

Hemato

Hemato: 1009

Acute respiratory failure: 62.4 %

Shock: 42.4 %

AKI: 30.5 %

Coma: 22.3 %

Urgent chemo: 6.9 %

AKIN

During ICU stay: 66.5 %

AKIN1: 38.4 %

AKIN2: 11.2 %

AKIN3: 50.4 %

Nephrotoxic agents:25.3 %

Sepsis/shock: 31.3 %

Hospital mortality: 44.3 %

AKIN stage dependent

Hospital mortality: 25.4 %

RRT: 271 (26.9 %)

RRT-AKIN

AKIN1: 19.6 %

AKIN2: 9.9 %

AKIN3: 64.2 %

CRRT: 136 pts

IHD: 135 pts

12.9 % of survivors RRT dependent

  1. AKI acute kidney injury, AKIN Acute Kidney Injury Network, ca pts cancer patients, chemo chemotherapy, CRRT, continuous renal replacement therapy, CVVHDF continuous venovenous hemodiafiltration, CVVHF continuous venovenous hemofiltration, hemato hematology, IHD intermittent hemodialysis, KDIGO and Kidney Diseases Improving Global Outcomes, onco oncology, pts patients, RIFLE Risk, Injury, Failure, Loss, End stage renal disease, RRT renal replacement therapy, SCr serum creatinine, TLS tumor lysis syndrome, ATN acute tubular necrosis