IMPACT OF CHEMOTHERAPY ON ELECTROLYTES AND MORTALITY IN ONCOLOGIC PATIENTS WITH ACUTE KIDNEY INJURY: RISK FACTORS AND PREDICTORS

 

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IMPACT OF CHEMOTHERAPY ON ELECTROLYTES AND MORTALITY IN ONCOLOGIC PATIENTS WITH ACUTE KIDNEY INJURY: RISK FACTORS AND PREDICTORS

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JUAN DANIEL
ACOSTA GONZALEZ
JUAN DANIEL ACOSTA GONZALEZ juadacostanefro1984@gmail.com Catholic University "Our Lady of the Assumption/Central Hospital of the Social Security Institute Nephrology Asunción Paraguay *
MARÍA DEL CARMEN ROMERO mariarom@ips.gov.py Catholic University "Our Lady of the Assumption/Central Hospital of the Social Security Institute Nephrology Asunción Paraguay -
 
 
 
 
 
 
 
 
 
 
 
 
 

Cancer patients, especially those receiving chemotherapy and immunotherapy, may present with acute or chronic kidney injury due to the toxic effects of treatments, comorbidities, and other factors. Early detection and assessment of changes in clinical and laboratory variables upon admission and discharge are essential to optimize management and improve outcomes. However, there is a need to better understand the factors associated with kidney injury in this group of patients in our local context. Objective: To analyze the impact of chemotherapy on electrolyte disturbances in cancer patients with AKI and to identify predictors of mortality.


A retrospective study was conducted at the Central Hospital of the Social Security Institute, including the medical records of cancer patients who required nephrology consultation for acute kidney injury between 2021 and 2024. Variables such as age, sex, origin, comorbidities, hemoglobin, hematocrit, urea, creatinine, uric acid, PCR, glomerular filtration rate, electrolytes, calcium, phosphorus, and magnesium were collected at both admission and discharge. In addition, the cancer diagnosis and treatments received (chemotherapy, immunotherapy) were recorded. Analysis: t-test, Mann-Whitney, Chi-square, Pearson correlation.




Images must be in JPEG or PNG format (uploaded images cannot exceed 640w x 480h pixels and 1.5 MB).Age: 65.2±12.8 years; female: 54,1%; mortality: 21.6%. Most common abnormalities: hypocalcemia (66.2%), hyperphosphatemia (52.7%), and hyponatremia (29.7%). Chemotherapy increased the risk of hyponatremia (35.1% vs. 11.8%, RR=2.97) and hypomagnesemia (28.1% vs. 11.8%, RR=2.38), without statistical significance. 
Mortality difference by sex: p-value = 0.9538; Glomerular filtration rate difference by sex: p-value = 0.0353
Significant predictors of mortality: serum phosphorus at discharge (r=0.421, p<0.001), change in phosphorus (r=0.312, p=0.007), and potassium at discharge (r=0.285, p=0.014). Carboplatin caused greater hypocalcemia (-0.8 mg/dL) and hypomagnesemia (-0.2 mg/dL)



 Age: 65.2±12.8 years; female: 54,1%; mortality: 21.6%. Most common abnormalities: hypocalcemia (66.2%), hyperphosphatemia (52.7%), and hyponatremia (29.7%). Chemotherapy increased the risk of hyponatremia (35.1% vs. 11.8%, RR=2.97) and hypomagnesemia (28.1% vs. 11.8%, RR=2.38), without statistical significance. Age: 65.2±12.8 years; female: 54,1%; mortality: 21.6%. Most common abnormalities: hypocalcemia (66.2%), hyperphosphatemia (52.7%), and hyponatremia (29.7%). Chemotherapy increased the risk of hyponatremia (35.1% vs. 11.8%, RR=2.97) and hypomagnesemia (28.1% vs. 11.8%, RR=2.38), without statistical significance. 
Mortality difference by sex: p-value = 0.9538; Glomerular filtration rate difference by sex: p-value = 0.0353
Significant predictors of mortality: serum phosphorus at discharge (r=0.421, p<0.001), change in phosphorus (r=0.312, p=0.007), and potassium at discharge (r=0.285, p=0.014). Carboplatin caused greater hypocalcemia (-0.8 mg/dL) and hypomagnesemia (-0.2 mg/dL)


Mortality difference by sex: p-value = 0.9538; Glomerular filtration rate difference by sex: p-value = 0.0353
Significant predictors of mortality: serum phosphorus at discharge (r=0.421, p<0.001), change in phosphorus (r=0.312, p=0.007), and potassium at discharge (r=0.285, p=0.014). Carboplatin caused greater hypocalcemia (-0.8 mg/dL) and hypomagnesemia (-0.2 mg/dL)








Age: 65.2±12.8 years; female: 54,1%; mortality: 21.6%. Most common abnormalities: hypocalcemia (66.2%), hyperphosphatemia (52.7%), and hyponatremia (29.7%). Chemotherapy increased the risk of hyponatremia (35.1% vs. 11.8%, RR=2.97) and hypomagnesemia (28.1% vs. 11.8%, RR=2.38), without statistical significance. Mortality difference by sex: p-value = 0.9538; Glomerular filtration rate difference by sex: p-value = 0.0353. Significant predictors of mortality: serum phosphorus at discharge (r=0.421, p<0.001), change in phosphorus (r=0.312, p=0.007), and potassium at discharge (r=0.285, p=0.014). Carboplatin caused greater hypocalcemia (-0.8 mg/dL) and hypomagnesemia (-0.2 mg/dL)

Chemotherapy is associated with an increased risk of specific electrolyte disturbances in cancer patients with AKI. Serum phosphorus is the strongest electrolyte predictor of in-hospital mortality. Intensive electrolyte monitoring and development of prognostic scores are required in onconephrology.


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