Outcomes of Acute Kidney Injury Patients with and Without Cancer: A Single Center Study

Abstract

Background: Acute kidney injury (AKI) is a frequent complication in hospitalized patients. Incidence of AKI in hospitalized patients with cancer is increasing, but there have been few studies on AKI in patients with cancer. The purposes of this study were: 1. To evaluate and compare the characteristics and outcomes of cancer and non-cancer AKI patients; 2. To determine the impact of cancer diagnosis on hospital mortality of AKI patients; and 3. To compare outcome predictors between the two groups of AKI patients. Methods: We conducted a retrospective cohort study in a South Korean tertiary care hospital. A total of 2211 consecutive patients (without cancer 61.5%; with cancer 38.5%) were included over a 140-month period. Predictors of all-cause death were examined using the Kaplan-Meier method and the Cox proportional hazards model. Results: The main contributing factors of AKI were sepsis (31.1%) and ischemia (52.7%). AKI was multifactorial in 78% of patients with cancer and in 71% of patients without cancer. Hospital mortality rates were higher in patients with cancer (42.8%) than in patients without cancer (22.5%) (P = 0.014). In multivariate analyses, diabetes mellitus (DM) and cancer diagnosis were associated with hospital mortality. Cancer diagnosis was independently associated with mortality [odds ratio = 3.010 (95% confidence interval, 2.340-3.873), P = 0.001]. Kaplan-Meier analysis revealed that subjects with DM and cancer (n = 146) had lower survival rates than subjects with DM and without cancer (n = 687) (log rank test, P = 0.001). Conclusion: The presence of DM and cancer were independently associated with mortality in AKI patients both with and without cancer. Studies are warranted to determine whether proactive measures may limit AKI and improve outcomes.