Predictors of Acute Kidney Injury in Hematological Cancer Patients: A Prospective Cross-Sectional Study Publisher



Ghasemi M¹ ; Solduzian M² ; Shahrabi M¹ ; Taghvayemasoumi H³ ; Hadjibabaei M^{1, 4} ; Zadeh HK⁵ ; Sadeghi K¹ Show Affiliations
Source: Turkish Journal of Nephrology Published:2023

Abstract

Objective: Data about the contribution of drugs to the development of acute kidney injury are scarce in hematological cancer patients. The current study evaluated the relationship between the use of different medications and acute kidney injury development in hematological cancer patients. Methods: This study was designed as a prospective observational cross-sectional study. All patients admitted to hematology wards of Shariati Hospital of Tehran University of Medical Sciences were evaluated, and patients younger than 18 years of age, those who were not able to consent to participate and those who presented with acute kidney injury were excluded. Acute kidney injury was diagnosed per KDIGO criteria. Results: Overall, 450 patients were evaluated in this study and 138 cases of acute kidney injury were detected; this translates into 30.6% incidence rate in hematology wards of the study center. The median age of the patients with acute kidney injury was 49 years and 84 (60.9%) of them were men. Length of hospital stay and mortality rate was significantly higher in patients with acute kidney injury than those without (P < .001 and < .001, respectively). Results of the multivariate analysis showed that treatment with vancomycin (odds ratio 1.77), the combination of vancomycin and amphotericin B deoxycholate (odds ratio 3.10), and idarubicin (odds ratio 2.10) could significantly increase the odds of acute kidney injury development in patients with hematological malignancy, but treatment with hydrocortisone (odds ratio 0.26) could have significant nephroprotective effects. Conclusion: This study showed that treatment with vancomycin, the combination of vancomycin and amphotericin B deoxycholate, and idarubicin could significantly increase the odds of acute kidney injury development. Hydrocortisone treatment showed significant nephroprotective effects. Mortality and duration of hospital stay were significantly higher in patients with acute kidney injury. © 2023 Turkish Society of Nephrology. All rights reserved.