- Cancer-related acute kidney injury (AKI) affects nearly 1 in 10 patients.
- Risk appears heightened within 90 days of systemic therapy.
Why this matters
- Study sheds light on AKI burden and risk factors in this population.
- Canadian population-based study of 163,071 newly diagnosed adults (mean age, 61.89 years) initiating systemic cancer therapy (chemotherapy/targeted agents) during 2007-2014.
- Funding: Institute for Clinical Evaluative Sciences.
- 10,880 (6.7%) required hospitalization/dialysis for AKI.
- Incidence rate, 27 per 1000 person-years (PY).
- Annual incidence increased from 2007 to 2014 (18-52 per 1000 PY).
- Cumulative incidence, 9.3% (95% CI, 9.1%-9.6%).
- AKI risk was exacerbated in the first 90 days after systemic therapy (aHR=2.34; P<.001>
- Median time from most recent systemic therapy exposure to AKI, 33 (interquartile range, 9-177) days.
- Malignancies with highest 5-year AKI incidence:
- Myeloma: 26.0% (95% CI, 24.4%-27.7%).
- Bladder cancer: 19.0% (95% CI, 17.6%-20.5%).
- Leukemia: 15.4% (95% CI, 14.3%-16.5%).
- Risk factors included advanced cancer stage (aHR=1.41), chronic kidney disease (aHR=1.80), and diabetes (aHR=1.43, all P<.001>
- Among older patients (age ≥66 years) with universal drug benefits, AKI risk rose with concomitant use of:
- Diuretics: aHR=1.20 (P<.001>
- Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs): aHR=1.30 (P<.001>
- Less-severe AKI not captured.
- Potential confounding from comorbidities.