Acute Kidney Injury Classified by Serum Creatinine and Urine Output in Critically Ill Cancer Patients

Abstract EN

Acute kidney injury (AKI) is common in critically ill patients and is associated with higher mortality.

Cancer patients are at an increased risk of AKI.

Our objective was to determine the incidence of AKI in our critically ill cancer patients, using the criteria of serum creatinine (SCr) and urine output (UO) proposed by the Kidney Disease: Improving Global Outcomes (KDIGO).

Methods.

We performed a retrospective cohort analysis of a prospectively collected database at the intensive care unit (ICU) of the Instituto Nacional de Cancerología from January 2013 to March 2015.

Results.

We classified AKI according to the KDIGO definition.

We included 389 patients; using the SCr criterion, 192 (49.4%) had AKI; using the UO criterion, 219 (56.3%) had AKI.

Using both criteria, we diagnosed AKI in 69.4% of patients.

All stages were independently associated with six-month mortality; stage 1 HR was 2.04 (95% CI 1.14–3.68, p=0.017), stage 2 HR was 2.73 (95% CI 1.53–4.88, p=0.001), and stage 3 HR was 4.5 (95% CI 2.25–8.02, p<0.001).

Patients who fulfilled both criteria had a higher mortality compared with patients who fulfilled just one criterion (HR 3.56, 95% CI 2.03–6.24, p<0.001).

Conclusion.

We diagnosed AKI in 69.4% of patients.

All AKI stages were associated with higher risk of death at six months, even for patients who fulfilled just one AKI criterion.