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Over the last two decades, major advancements in oncology have improved patients’ overall survival. However, cancer-related complications, either related to the disease itself or to therapy, have also been increasingly recognized. Acute kidney injury (AKI) remains a major problem in this setting, resulting in longer hospitalizations, withdrawal from oncological treatments, and ultimately, worse prognosis. This study aimed to describe a population of patients with cancer and severe AKI admitted to a Comprehensive Cancer Center.
This single-center cohort study included 3201 patients with cancer and severe AKI admitted to a Comprehensive Cancer Center between January 1995 and July 2023. Severe AKI was defined as grade ≥ 2 AKI according to KDIGO guidelines and nephrological in-hospital follow-up. Patients without indications for cardiopulmonary resuscitation or those previously referred for palliative care were excluded. Data were collected from electronic medical records and analyzed in two timelines: from 1995-2010 (Period A) and from 2011-2023 (Period B). Statistical analysis was performed using the SPSS ® 26.0.
This study highlights a paradigm shift in this context over the last decade. On the one hand, AKI has affected older patients and nephrotoxicity has become a far more relevant cause. However, AKI has been less frequently associated with hematological diseases and in-hospital mortality. Given its incidence and further consequences, identifying the causes and risk factors for severe AKI is crucial for prevention and prognosis improvement in cancer patients.