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Acute kidney injury risk and prevention in patients undergoing treatment for lung cancer
Lewis, A Ladan, Z Al-Sayed, Tamer Campbell, G
Lewis, A
Ladan, Z
Al-Sayed, Tamer
Campbell, G
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Abstract
Introduction: Oncology patients have increased risk of acute kidney
injury (AKI) often due to dehydration and nephrotoxic chemotherapy
agents. This study's purpose was to assess the risk of developing AKI
during lung cancer treatment using an evaluation tool.
Methods: Objectives included determining the tool's positive
predictive value, identifying high risk characteristics and ultimately
reducing AKI incidence. A retrospective analysis was conducted
using the electronic notes of 245 patients diagnosed with stage IV
lung cancer from 2013 to 2018.
Results: 144 received chemotherapy as lung cancer treatment
and 12 subsequently developed AKI. Comparing the AKI and non-
AKI populations the following results were found: mean weight of
85.77kg and 70.88kg respectively (p=0.040), ECOG 3 performance
status in 50% of AKI patients compared to 17.4% (p=0.049) and
baseline serum creatinine (SCr) was 99.1 mol/L and 73.1 mol/L
respectively (p=0.017). The difference in incidence of the tool
criteria - CKD, heart failure, chronic liver disease, diabetes, previous
AKI and nephrotoxic drugs - between the 2 groups held no
statistical significance. Further analysis of the diabetic population
(considering 41.7% incidence in the AKI population), found the mean
baseline SCr was greater in the in the diabetic AKI population (111
mol/L vs. 78.1 mol/L, p=0.005). Dehydration was the AKI cause in
41.67% and 58.33% were taking a statin at the commencement of
chemotherapy treatment. The tool's sensitivity and specificity are 14.52% and 96.39% respectively. Conclusion: In conclusion, although AKI risk assessment tool was
not able to predict AKI in this study it may have been affected by
the limited population size of this retrospective analysis. However,
it does identify that patients with higher body mass, poorer
performance status and diabetes represent a high proportion of AKI
cases and special care is warranted when starting these patients on
therapy for lung cancer. Further prospective studies are warranted
in this area.
Description
Date
2019
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Lewis A, Ladan Z, Al-Sayed T, Campbell G, Blackhall F. Acute kidney injury risk and prevention in patients undergoing treatment for lung cancer. Lung Cancer. 2019;127:S49-S.