1326: OUTCOMES OF ACUTE KIDNEY INJURY IN HEMATOLOGIC CANCER PATIENTS WITH SEPTIC SHOCK

Кidney injury is a frequent and significant complication of cancer and cancer therapy. The kidneys are susceptible to injury from malignant infiltration, damage by metabolites of malignant cells, glomerular injury, nephrotoxic drugs including chemotherapeutic agents. Also bone marrow transplantation complications, infections with immune suppression (including septicemia), tumor lysis syndrome should be taken into account. Chemotherapeutic agents are a common cause of acute kidney injury but can potentially lead to chronic kidney disease development in cancer patients. This article summarizes risk factors of acute kidney injury in cancer patients. Risk factors are divided into two groups. The systemic are decrease of total circulating blood volume, infiltration of kidney tissue by tumor cells, dysproteinemia, electrolyte disturbances. The local (renal) risk factors are microcirculation disturbances, drugs biotransformation with formation of reactive oxygen intermediates, high concentration of nephrotoxic agents in proximal tubules and its sensitivity to ischemia. Drug-related risk factors include: drugs combination with cytotoxic effect high doses long term use necessity, direct cytotoxic effect of not only chemotherapeutic agents but also its metabolites, mean solubility forming intratubular precipitates. Early diagnosis, timely prevention and treatment of these complications provide significantly improve nononcologic results of treatment.

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Faculty Opinions recommendation of Histopathology of septic shock induced acute kidney injury: apoptosis and leukocytic infiltration.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1168327.630494 ◽

2009 ◽

Author(s):

Matthieu Legrand

Keyword(s):

Septic Shock ◽

Acute Kidney Injury ◽

Kidney Injury ◽

Leukocytic Infiltration

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Faculty Opinions recommendation of BCL2 genetic variants are associated with acute kidney injury in septic shock*.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717952982.793458534 ◽

2012 ◽

Author(s):

Nigel Webster

Keyword(s):

Septic Shock ◽

Acute Kidney Injury ◽

Genetic Variants ◽

Kidney Injury

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Association between Procalcitonin and Acute Kidney Injury in Patients with Bacterial Septic Shock

Blood Purification ◽

10.1159/000512351 ◽

2021 ◽

pp. 1-10

Author(s):

Guang Fu ◽

Hai-chao Zhan ◽

Hao-li Li ◽

Jun-fu Lu ◽

Yan-hong Chen ◽

...

Keyword(s):

Septic Shock ◽

Acute Kidney Injury ◽

Logistic Regression ◽

Piecewise Linear ◽

Kidney Injury ◽

Multiple Logistic Regression ◽

Primary Analysis ◽

Female Patients ◽

Potential Biomarker ◽

The Relationship

Objective: The objective of this study was to assess the relationship between serum procalcitonin (PCT) and acute kidney injury (AKI) induced by bacterial septic shock. Methods: A retrospective study was designed which included patients who were admitted to the ICU from January 2015 to October 2018. Multiple logistic regression and receiver operating characteristic (ROC) as well as smooth curve fitting analysis were used to assess the relationship between the PCT level and AKI. Results: Of the 1,631 patients screened, 157 patients were included in the primary analysis in which 84 (53.5%) patients were with AKI. Multiple logistic regression results showed that PCT (odds ratio [OR] = 1.017, 95% confidence interval [CI] 1.009–1.025, p < 0.001) was associated with AKI induced by septic shock. The ROC analysis showed that the cutoff point for PCT to predict AKI development was 14 ng/mL, with a sensitivity of 63% and specificity 67%. Specifically, in multivariate piecewise linear regression, the occurrence of AKI decreased with the elevation of PCT when PCT was between 25 ng/mL and 120 ng/mL (OR 0.963, 95% CI 0.929–0.999; p = 0.042). The AKI increased with the elevation of PCT when PCT was either <25 ng/mL (OR 1.077, 95% CI 1.022–1.136; p = 0.006) or >120 ng/mL (OR 1.042, 95% CI 1.009–1.076; p = 0.013). Moreover, the PCT level was significantly higher in the AKI group only in female patients aged ≤75 years (p = 0.001). Conclusions: Our data revealed a nonlinear relationship between PCT and AKI in septic shock patients, and PCT could be used as a potential biomarker of AKI in female patients younger than 75 years with bacterial septic shock.

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