A single-center study of cancer and chemotherapy-induced kidney disease.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13062-e13062
Author(s):  
Abu-Sayeef Mirza ◽  
Sarah Mushtaq ◽  
Revati Reddy ◽  
Mina Mousa ◽  
Chandrashekar Bohra ◽  
...  

e13062 Background: It is clinically understood that chronic kidney disease (CKD) and cancer are interrelated. Yet, few studies measure how renal outcomes vary according to common malignancies and common therapeutic agents. We report the incidence and the nature of CKD among cancer patients from a single institution. Methods: A retrospective chart review of cancer patients managed in the onconephrology clinic at the Moffitt Cancer Center from 05/01/2015 to 07/31/2016 was conducted. Patients with acute or chronic kidney disease secondary to a malignancy or side effect of chemotherapy were included in this study. Renal function outcomes were recorded at three-month follow-up intervals from the 15-month duration. Results: Out of the total 88 patients with median age of 68 years, 63 patients were diagnosed with chronic kidney disease, whereas the remaining had acute kidney injury. Kidney cancer and multiple myeloma represented the largest proportion with 12 patients each. Patients with kidney cancer had a mean creatinine of (2.35, 1.74) mg/dl compared to patients without kidney cancer with creatinine (1.97, 1.07) mg/dl. Abdominal cancers had the highest proportion of chronic kidney disease (84.21%) whereas 81.48% of patients with genitourinary cancers had chronic kidney disease. Patients prescribed tyrosine kinase inhibitors had a lower average estimated glomerular filtration rate (28.37, 9.86) mL/min/1.73 m2 compared to other chemotherapeutic agents, though this was a weakly significant relationship (p-value = 0.07). Similar renal outcomes according to malignancy and chemotherapy are reported. Conclusions: This group of patients demonstrated the frequency of chronic kidney disease differs depending on the type of malignancy or chemotherapy. A multidisciplinary approach involving oncologists and nephrologists should be adopted to prevent further renal damage from cancer and its therapies.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18815-e18815
Author(s):  
Omar Mamlouk ◽  
Anastasia Turin ◽  
David D'Achiardi ◽  
Cesar Simbaqueba ◽  
Kodwo Dickson ◽  
...  

e18815 Background: Coronavirus disease 2019 (COVID-19) has been associated with higher risk of acute kidney injury (AKI) and mortality rate in cancer patients. The prevalence of CKD in cancer patients is close to 20-30% however there has been limited data about cancer patients with CKD and COVID-19 infection. The aim of this study is to evaluate the clinical characteristics and outcomes of this patient population at a tertiary cancer center. Methods: All patient data — demographics, labs, comorbidities and outcomes — were aggregated and analyzed in the Syntropy platform, Palantir Foundry (“Foundry”), as part of the Data-Driven Determinants of COVID-19 Oncology Discovery Effort (D3CODE) protocol at MD Anderson. The cohort was defined by the following: (1) positive COVID-19 test; (2) baseline eGFR 15-59 ml/min/1.73m2 calculated by chronic kidney disease epidemiology collaboration equation. The baseline GFR and creatinine values used the most temporally proximal lab results within 30 days prior to the patient’s infection. AKI was defined as an absolute change of creatinine ≥0.3 mg/dl above the baseline after the positive COVID-19 test. Results: Out of 790 patients with COVID-19,19.6% had underlying CKD. Among these, 86.5% and 46.5% had history of hypertension and diabetes mellitus, respectively. 77.3% had a solid malignancy and 87.3% of them had metastatic disease. 67.7% were asymptomatic, 14.2% required ICU admission, 10.3% required invasive ventilation support, and 11.6% died within 90 days of the COVID-19 test. AKI developed within the first 30 days in 61.3% and 8.4% required renal replacement therapy. AKI was more prevalent in patients who were hospitalized (84.2% vs. 31.7%, p< 0.001), had concurrent pneumonia (63.3% vs. 36.8%, p< 0.002), required critical care (68.3% vs. 15.8% , p< 0.001), and were on ventilation support (16.8% vs. 0%, p=0.002). There was no significant statistical difference in rates of diabetes (52.6% vs. 36.7%, P of 0.076), tumor staging (metastasis; 95.1% vs. non metastatic 82.6%, p< 0.2) , readmission rate (52.6% vs. 43.3%, p=0.336), and death rate at 30 days (9.5% vs. 3.3%, p=0.205) between the two groups. Conclusions: The overall mortality rate of cancer patients with CKD and positive COVID-19 test was relatively high and close to 1.7 times the rate of patients with no CKD at our tertiary cancer center. AKI is a common complication in CKD patients with concurrent pneumonia and requiring ventilation support, and was associated with increased morality at 90 days.


2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Kelly O'Donnell ◽  
Conrad Tobert ◽  
Brad Boelkins ◽  
Sabrina Noyes ◽  
Samer Kirmiz ◽  
...  

2018 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Abdul Wakhid ◽  
Estri Linda Wijayanti ◽  
Liyanovitasari Liyanovitasari

Background: Self efficacy can optimize the quality of life of clients who undergo the healing process due to chronic diseases. Individuals with higher self-efficacy move their personal and social resources proactively to maintain and improve the quality and length of their lives so that they experience a better quality of life. Objectives: the purpose of this study was to find the correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency. Metode: This type of research was descriptive correlation with cross sectional approach. The samples in this study more 76 people with total sampling technique. The data collection tool for self efficacy was measured by General Self-Efficacy scale, for quality of life with WHOQoL-BREF. Statistical test used Kolmogorov-smirnov. Result: The result showed that self efficacy in patients with chronic kidney disease was mostly in moderate category (53,9%), quality of life in patients with chronic kidney disease was mostly in good category (68,4%). There was a correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency, the result obtained p-value of 0.000 <α (0,05). Suggestion: Patients with chronic kidney disease can maintain good quality of life by helping to generate positive self-esteem and high self efficacy.


Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1705
Author(s):  
Elena De Mattia ◽  
Jerry Polesel ◽  
Rossana Roncato ◽  
Adrien Labriet ◽  
Alessia Bignucolo ◽  
...  

A new paradigm in cancer chemotherapy derives from the interaction between chemotherapeutics, including irinotecan and 5-fluorouracil (5-FU), and the immune system. The patient’s immune response can modulate chemotherapy effectiveness, and, on the other hand, chemotherapeutic agents can foster tumor cell immunogenicity. On these grounds, the analysis of the cancer patients’ immunogenetic characteristics and their effect on survival after chemotherapy represent a new frontier. This study aims to identify genetic determinants in the immuno-related pathways predictive of overall survival (OS) after FOLFIRI (irinotecan, 5-FU, leucovorin) therapy. Two independent cohorts comprising a total of 335 patients with metastatic colorectal cancer (mCRC) homogeneously treated with first-line FOLFIRI were included in the study. The prognostic effect of 192 tagging genetic polymorphisms in 34 immune-related genes was evaluated using the bead array technology. The IL15RA rs7910212-C allele was associated with worse OS in both discovery (HR: 1.57, p = 0.0327, Bootstrap p-value = 0.0280) and replication (HR:1.71, p = 0.0411) cohorts. Conversely, SMAD3 rs7179840-C allele was associated with better OS in both discovery (HR:0.65, p = 0.0202, Bootstrap p-value = 0.0203) and replication (HR:0.61, p = 0.0216) cohorts. A genetic prognostic score was generated integrating IL15RA-rs7910212 and SMAD3-rs7179840 markers with inflammation-related prognostic polymorphisms we previously identified in the same study population (i.e., PXR [NR1I2]-rs1054190, VDR-rs7299460). The calculated genetic score successfully discriminated patients with different survival probabilities (p < 0.0001 log-rank test). These findings provide new insight on the prognostic value of genetic determinants, such as IL15RA and SMAD3 markers, and could offer a new decision tool to improve the clinical management of patients with mCRC receiving FOLFIRI.


2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Lee-Moay Lim ◽  
Hung-Tien Kuo ◽  
Mei-Chuan Kuo ◽  
Yi-Wen Chiu ◽  
Jia-Jung Lee ◽  
...  

2021 ◽  
pp. 75-76
Author(s):  
Bharat Bhushan ◽  
Debarshi Jana

Background: Dyslipidemia is very much common in chronic kidney disease patients and is responsible for cardiovascular disease (CKD) which is most common cause of mortality in them. So, it is necessary to study the lipid prole in CKD patients to prevent morbidity and mortality. Methods: Subjects each of 50 in number are grouped into healthy controls (group-1), CKD patients without hemodialysis (group-2), CKD patients with hemodialysis (group-3). After fasting of 12 hours, lipid prole is assessed in all cases. Results: In this study, there is increase in Total cholesterol (TC), Low Density lipoprotein (LDL), very Low-Density lipoprotein (VLDL) and Triglycerides (TG) and decrease in High Density Lipoprotein (HDL) in all CKD patients compared to healthy controls (p-value for each parameter <0.001). There is increase in TC, TG and VLDL in diabetic CKD patients compare to non-diabetic CKD patients and p-value for each parameter is <0.05. It was found that TG and VLDL increase and HDL decrease in group-3 compare to group-2 is statistically signicant (p-value for each <0.05) and no signicant variation in TC and LDL in these groups. Conclusions: Present study demonstrated that there is dyslipidemia in CKD patients irrespective of mode of management, but the derangement is much more common and signicant in CKD with hemodialysis group and they are at risk of cardiovascular disease. It is better to start lipid lowering drugs which decreases disease progression and dyslipidemia.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Pietro Manuel Ferraro ◽  
Alessandra Nicolosi ◽  
Alessandro Naticchia ◽  
Nicola Panocchia ◽  
Giuseppe Grandaliano ◽  
...  

Abstract Background and Aims Chronic kidney disease is a frequent condition, characterized, especially in its more advanced stages, by an array of derangements in bone structure and density, resulting in a higher rate of bone fractures. Current strategies to monitor the bone status and assess the risk of bone fractures in CKD patients are limited. The Bone Elastic Structure (BES) test is a recently-developed non-invasive tool that measures the elastic characteristics of the trabecular bone by simulating the application of loads on a virtual biopsy obtained from radiographic images of the proximal epiphyses in the patient’s hand fingers. The simulation results are combined to obtain a parameter defined Bone Structure Index (BSI). The aim of our study is to explore whether the BES test could be a useful monitoring tool of bone status in patients with CKD on dialysis by exploring whether such patients have different BSI values compared with persons without CKD. Method The BES test was performed on a sample of 41 patients undergoing chronic hemodialysis (HD) and the BSI compared with a group of 374 persons with normal renal function who had undergone the BES test in previous studies. Differences in BSI and 95% confidence intervals (CIs) between the two groups were obtained and tested for statistical significance with a linear regression model including BSI as the dependent variable and kidney status (HD vs no HD) as the independent variable, adjusted for age and sex. Subgroup effects were explored by including interaction terms (age x kidney status, age x sex, kidney status x sex) in the model. Finally, to further remove the potential confounding by age and sex, each HD patient was individually matched with up to 4 non-HD participants based on sex and age (with a 5-year caliper) and a matched analysis was conducted on BSI values. Results Average (SD) age was 64 (17) years in the HD group and 60 (12) years in the non-HD group, with a prevalence of males of 49% and 16%, respectively. The individual values of BSI divided by kidney status and sex in Figure. The multivariate linear regression model showed that, after adjustment for age and sex, the BSI in the HD group was significantly lower compared with the non-HD group (HD 145, 95% CI 140, 154; non-HD 179, 95% CI 177, 181; absolute difference −32, 95% CI −40, −25; p-value &lt; 0.001). There was no significant interaction between age, sex and kidney status on BSI values (all p-values &gt; 0.05). Individual matching was successful for 36 out of 41 HD patients, who were matched to 127 non-HD participants; matched analysis confirmed the results (absolute difference −31, 95% CI −40, −23; p-value &lt; 0.001). Conclusion The output of a non-invasive tool to determine the bone elastic structure appeared to be strongly associated with kidney function after control for differences in age and sex. Further studies are needed to determine the potential application of the BES test in patients with CKD.


2013 ◽  
Vol 10 (5) ◽  
pp. 575-584 ◽  
Author(s):  
Szu-Chia Chen ◽  
Jer-Ming Chang ◽  
Yi-Chun Tsai ◽  
Jiun-Chi Huang ◽  
Ho-Ming Su ◽  
...  

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