Dr Claire Johnston1,2, Dr Eleanor Tripp1, Dr Arunima Jain1,2,3, Dr Maria Mawaad1, Prof Zoltan Endre1,2, Dr Jonathan Erlich1,2
1Prince Of Wales Hospital, Sydney, Randwick, Australia, 2University of New South Wales , Randwick , Australia, 3Royal Hospital for Women , Randwick , Australia
Biography:
Dr Claire Johnston is currently the AKI Fellow at Prince of Wales hospital. She completed her renal advanced training in the East Coast Renal Network in NSW, as well as time in the Top End Renal Service in the NT. Her areas of interest are Onco-Nephrology and renal drug pharmacokinetics.
Aim:
To review characteristics, management and outcomes of patients with cancer who experienced an acute kidney injury (AKI) during hospital admission, compared to those without cancer.
Background:
AKI is common among those with cancer and the incidence of both cancer and kidney disease is increasing. Identification of AKI, treatment and outcomes for those with cancer is an area of scarce evidence.
Methods:
All patients who were referred for an AKI consult from November 2022 to December 2024 were included.
Results:
Of 326 patients there were 69 (21%) with active cancer, 46 (14%) with treated cancer and 212 (56%) without cancer. Patients with active or treated cancer and AKI were more likely to die in hospital (p <0.017) and those with active but not treated cancer had a 3.0 fold risk of mortality over up to 4 years (p <0.006). The majority of patients spent less than 50 days in hospital (336 of 337). Of these the median length of stay was 15 days for treated cancer, 14 days for active and 11 days for no cancer (p=0.33). For patients with up to 3 admissions (n=322), those with active cancer had a 2.4 fold increased risk of a second or 3rd admission (p <0.007). There was a trend to higher rates of ICU admission and renal replacement therapy in active cancer patients.
Conclusion:
AKI is a major risk factor for death with both treated and active cancer and is also associated with increased length of stay and readmission. Factors associated with these risks need to be identified and special attention paid to those with cancer with risk factors for AKI while in hospital.