Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy
Background Whether continuous renal replacement therapy (CRRT) should be applied to critically ill patients with both acute kidney injury (AKI) and cancer remains controversial because of poor expected outcomes. The present study determined prognostic factors for all-cause in-hospital mortality in p...
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2022-11-01
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| Series: | Kidney Research and Clinical Practice |
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| Online Access: | http://www.krcp-ksn.org/upload/pdf/j-krcp-21-305.pdf |
| _version_ | 1811197599304122368 |
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| author | Da Woon Kim Geum Suk Jang Kyoung Suk Jung Hyuk Jae Jung Hyo Jin Kim Harin Rhee Eun Young Seong Sang Heon Song |
| author_facet | Da Woon Kim Geum Suk Jang Kyoung Suk Jung Hyuk Jae Jung Hyo Jin Kim Harin Rhee Eun Young Seong Sang Heon Song |
| author_sort | Da Woon Kim |
| collection | DOAJ |
| description | Background Whether continuous renal replacement therapy (CRRT) should be applied to critically ill patients with both acute kidney injury (AKI) and cancer remains controversial because of poor expected outcomes. The present study determined prognostic factors for all-cause in-hospital mortality in patients with AKI and cancer undergoing CRRT. Methods We included 471 patients with AKI and cancer who underwent CRRT at the intensive care unit of a Korean tertiary hospital from 2013 to 2020, and classified them by malignancy type. The primary outcomes were 28-day all-cause mortality rate and prognostic factors for in-hospital mortality. The secondary outcome was renal replacement therapy (RRT) dependency at hospital discharge. Results The 28-day mortality rates were 58.8% and 82% in the solid and hematologic malignancy groups, respectively. Body mass index (BMI), presence of oliguria, Sequential Organ Failure Assessment (SOFA) score, and albumin level were common predictors of 28-day mortality in the solid and hematologic malignancy groups. A high heart rate and the presence of severe acidosis were prognostic factors only in the solid malignancy group. Among the survivors, the proportion with RRT dependency was 25.0% and 33.3% in the solid and hematologic malignancy groups, respectively. Conclusion The 28-day mortality rate of cancer patients with AKI undergoing CRRT was high in both the solid and hematologic malignancy groups. BMI, presence of oliguria, SOFA score, and albumin level were common predictors of 28-day mortality in the solid and hematologic malignancy groups, but a high heart rate and severe acidosis were prognostic factors only in the solid malignancy group. |
| first_indexed | 2024-04-12T01:16:28Z |
| format | Article |
| id | doaj.art-6c954d0405f64ed29c92fd38ec98ff7a |
| institution | Directory Open Access Journal |
| issn | 2211-9132 2211-9140 |
| language | English |
| last_indexed | 2024-04-12T01:16:28Z |
| publishDate | 2022-11-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-6c954d0405f64ed29c92fd38ec98ff7a2022-12-22T03:53:56ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322211-91402022-11-0141671772910.23876/j.krcp.21.3056157Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapyDa Woon Kim0Geum Suk Jang1Kyoung Suk Jung2Hyuk Jae Jung3Hyo Jin Kim4Harin Rhee5Eun Young Seong6Sang Heon Song7 Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea Department of Nursing, Pusan National University Hospital, Busan, Republic of Korea Department of Nursing, Pusan National University Hospital, Busan, Republic of Korea Department of Surgery, Pusan National University Hospital, Busan, Republic of Korea Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of KoreaBackground Whether continuous renal replacement therapy (CRRT) should be applied to critically ill patients with both acute kidney injury (AKI) and cancer remains controversial because of poor expected outcomes. The present study determined prognostic factors for all-cause in-hospital mortality in patients with AKI and cancer undergoing CRRT. Methods We included 471 patients with AKI and cancer who underwent CRRT at the intensive care unit of a Korean tertiary hospital from 2013 to 2020, and classified them by malignancy type. The primary outcomes were 28-day all-cause mortality rate and prognostic factors for in-hospital mortality. The secondary outcome was renal replacement therapy (RRT) dependency at hospital discharge. Results The 28-day mortality rates were 58.8% and 82% in the solid and hematologic malignancy groups, respectively. Body mass index (BMI), presence of oliguria, Sequential Organ Failure Assessment (SOFA) score, and albumin level were common predictors of 28-day mortality in the solid and hematologic malignancy groups. A high heart rate and the presence of severe acidosis were prognostic factors only in the solid malignancy group. Among the survivors, the proportion with RRT dependency was 25.0% and 33.3% in the solid and hematologic malignancy groups, respectively. Conclusion The 28-day mortality rate of cancer patients with AKI undergoing CRRT was high in both the solid and hematologic malignancy groups. BMI, presence of oliguria, SOFA score, and albumin level were common predictors of 28-day mortality in the solid and hematologic malignancy groups, but a high heart rate and severe acidosis were prognostic factors only in the solid malignancy group.http://www.krcp-ksn.org/upload/pdf/j-krcp-21-305.pdfacute kidney injurycontinuous renal replacement therapymalignancy |
| spellingShingle | Da Woon Kim Geum Suk Jang Kyoung Suk Jung Hyuk Jae Jung Hyo Jin Kim Harin Rhee Eun Young Seong Sang Heon Song Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy Kidney Research and Clinical Practice acute kidney injury continuous renal replacement therapy malignancy |
| title | Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy |
| title_full | Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy |
| title_fullStr | Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy |
| title_full_unstemmed | Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy |
| title_short | Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy |
| title_sort | hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy |
| topic | acute kidney injury continuous renal replacement therapy malignancy |
| url | http://www.krcp-ksn.org/upload/pdf/j-krcp-21-305.pdf |
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