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Hematological cancer represents a serious public health problem worldwide, with the advent of new therapeutics for their management, the survival of these patients has been prolonged, so it is essential to identify their effect in renal function. The objective was to compare the relationship between various chemotherapy regimens and the development of Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) in patients with Non-hodgkin's lymphoma (NHL).
Retrospective comparative survey. Convenience sampling was used. Inclusion criteria were histopathological diagnosis of NHL and exclusion criteria were previous diagnosis of CKD or lack of data in the medical record, during the years 2016 and 2021. The following data were collected in each file: age, gender, personal pathological history, date of NHL diagnosis, histological subtype, modality, and number of chemotherapy sessions, whether they received OM transplantation, surgical treatment, and radiotherapy. Time of onset was assessed in days and months and complications referred to in the medical notes. Descriptive statistics were used for data analysis.
30 files were analyzed, of which 14 were excluded, 16 patients were eligible for analysis and inclusion in the study as they had complete data. Regarding the demographic characteristics of the patients, 9 were male (56.25%) and 7 were female (43.75%), all with professional schooling, where most patients were in the 6th decade of life onwards (average age was 58.43 years). In terms of personal pathological history, 4 (25%) of the patients had type 2 diabetes mellitus and 3 patients (18.75%) had systemic arterial hypertension. In terms of chemotherapy schedules, different types of schemes were administered, R-CHOP was administered to most of them, 10 patients (62.5%), ERCHOP to 3 patients (18.75%) and other different schemes to 3 patient (18.75%). The subgroup of patients who received chemotherapy with RCHOP was analyzed in detail as it had the largest number of patients: The most frequent NHL subtype in this group was Diffuse Large B-cell with 9 patients (56.25%), other subtypes included: Mantle cell, T-cell, Follicular and indeterminate among the other 7 patients. In relation to the number of chemotherapy sessions 3 groups were generated: those who received > 6 sessions were 5 patients (50%), exclusively 6 sessions 3 patients (30%) and < 6 sessions 2 patients (20%); of the subgroup of patients who received R-CHOP their treatment was complemented with different interventions: 2 patients received BMT (20%), 4 patients received surgery (40%), 3 patients received RT (30%) and one patient died. In each patient the creatinine level was determined prior to the start of chemotherapy and 48 hr after the first chemotherapy session, GFR was calculated using the CKD EPI 2021 formula. Of the 16 patients analyzed, 7 had AKI (43.75%), 6 of them received R-CHOP, of which 4 developed CKD (52.14%).
In this study it was concluded that all patients who developed AKI after the first round and subsequently CKD had received the R-CHOP scheme. The relevance of this research lies in the need to improve medical care so that health personnel can identify and treat in a timely manner in order to prevent complications, as well as to provide significant data for medical support in care.