title: Incidence rate, clinical correlates, and outcomes of AKI in patients admitted to a comprehensive cancer center.
abstract: OBJECTIVE
  Incidence of AKI in hospitalized patients with cancer is increasing, but reports are scant. The objective of this study was to determine incidence rate, clinical correlates, and outcomes of AKI in patients admitted to a cancer center.
  
  
  METHODS
  Cross-sectional analysis of prospectively collected data on 3558 patients admitted to the University of Texas M.D. Anderson Cancer Center over 3 months in 2006.
  
  
  RESULTS
  Using modified RIFLE (Risk, Injury, Failure, Loss, ESRD) criteria, 12% of patients admitted to the hospital had AKI, with severity in the Risk, Injury, and Failure categories of 68%, 21%, and 11%, respectively. AKI occurred in 45% of patients during the first 2 days and in 55% thereafter. Dialysis was required in 4% of patients and nephrology consultation in 10%. In the multivariate model, the odds ratio (OR) for developing AKI was significantly higher for diabetes (OR, 1.89; 95% confidence interval [CI], 1.51-2.36), chemotherapy (OR, 1.61; 95% CI, 1.26-2.05), intravenous contrast (OR, 4.55; 95% CI, 3.51-5.89), hyponatremia (OR, 1.97; 95% CI, 1.57-2.47), and antibiotics (OR, 1.52; 95% CI, 1.15-2.02). In patients with AKI, length of stay (100%), cost (106%), and odds for mortality (4.7-fold) were significantly greater.
  
  
  CONCLUSIONS
  The rate of AKI in patients admitted to a comprehensive cancer center was higher than the rate in most noncancer settings; was correlated significantly with diabetes, hyponatremia, intravenous contrast, chemotherapy, and antibiotics; and was associated with poorer clinical outcomes. AKI developed in many patients after admission. Studies are warranted to determine whether proactive measures may limit AKI and improve outcomes.
authors.affiliation: Division of Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. aksalahudeen@mdanderson.org
authors.forename: Abdulla K
authors.initials: AK
authors.lastname: Salahudeen
authors.forename: Simit M
authors.initials: SM
authors.lastname: Doshi
authors.forename: Tushar
authors.initials: T
authors.lastname: Pawar
authors.forename: Gul
authors.initials: G
authors.lastname: Nowshad
authors.forename: Amit
authors.initials: A
authors.lastname: Lahoti
authors.forename: Pankaj
authors.initials: P
authors.lastname: Shah
mesh_terms: D000046:Academic Medical Centers / Q000191:economics; D058186:Acute Kidney Injury / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D003287:Contrast Media / Q000009:adverse effects; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007010:Hyponatremia / Q000453:epidemiology; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000191:economics / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D016017:Odds Ratio; D010343:Patient Admission; D011859:Radiography; D012017:Referral and Consultation; D006435:Renal Dialysis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D003287:Contrast Media