Acute Kidney Injury in Hospitalised Cancer Patients: Incidence, Risk Factors and Outcomes.

Abstract

Aim: Acute kidney injury (AKI) is a common complication in cancer patients and significantly impacts their treatment and prognosis. To better understand the epidemiology and clinical implications of AKI in hospitalised cancer patients, this study was designed to determine the incidence of AKI, identify risk factors for AKI and assess the impact of AKI on in-hospital outcomes.

Methods: Retrospective analysis of 68 379 cancer admissions in 2019. AKI incidence, risk factors (demographics, comorbidities and clinical characteristics), and impact on in-hospital mortality and length of stay were assessed. Logistic regression was employed to identify the risk factors for AKI. Survival analysis was conducted using the Cox proportional hazards model, with log-rank statistics used to assess survival outcome.

Results: Of the 68 379 eligible cancer admissions, 7734 AKI cases were recognised with an incidence rate of 11.3%. The highest rates were observed in renal cancer (40.1%), ureter cancer (27.9%) and multiple myeloma (16.1%). Clinical risk factors such as age > 50 years, body mass index < 18.5 kg/m², and hyperuricemia were significantly associated with hospital-acquired AKI compared to the non-AKI group (p < 0.001). In cases of severe community-acquired AKI, significant differences in hypertension, anaemia and leukocyte elevation were also observed (p < 0.001). The mortality rate was notably higher in AKI patients, especially in the severe AKI subgroup. The length of stay was markedly prolonged in patients with hospital-acquired and severe AKI, further underscoring the clinical burden of this complication.

Conclusion: Hospitalised cancer patients experience a high incidence of AKI. Identifying and mitigating risk factors may improve patient outcomes.