Acute kidney injury risk and prevention in patients undergoing treatment for lung cancer
AffiliationMedical Oncology, The Christie NHS Foundation Trust, Manchester
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AbstractIntroduction: 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.
CitationLewis 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.
TypeMeetings and Proceedings