title: Outcomes of cancer patients admitted to Brazilian intensive care units with severe acute kidney injury.
abstract: OBJECTIVE
  Critically ill cancer patients are at increased risk for acute kidney injury, but studies on these patients are scarce and were all single centered conducted in specialized intensive care units. The objective was to evaluate the characteristics and outcomes in a prospective cohort of cancer patients admitted to several intensive care units with acute kidney injury.
  
  
  METHODS
  Prospective multicenter cohort study conducted in intensive care units from 28 hospitals in Brazil over a two-month period. Univariate and multivariate logistic regression were used to identify factors associated with hospital mortality.
  
  
  RESULTS
  Out of all 717 intensive care unit admissions, 87 (12%) had acute kidney injury and 36% of them received renal replacement therapy. Kidney injury developed more frequently in patients with hematological malignancies than in patients with solid tumors (26% vs. 11%, P=0.003). Ischemia/shock (76%) and sepsis (67%) were the main contributing factor for and kidney injury was multifactorial in 79% of the patients. Hospital mortality was 71%. General and renal-specific severity-of-illness scores were inaccurate in predicting outcomes for these patients. In a multivariate analysis, length of hospital stay prior to intensive care unit, acute organ dysfunctions, need for mechanical ventilation and a poor performance status were associated with increased mortality. Moreover, cancer-related characteristics were not associated with outcomes.
  
  
  CONCLUSIONS
  The present study demonstrates that intensive care units admission and advanced life-support should be considered in selected critically ill cancer patients with kidney injury.
authors.affiliation: Unidade de Terapia Intensiva, Hospital de Câncer-I, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil.
authors.forename: Márcio
authors.initials: M
authors.lastname: Soares
authors.affiliation: Divisão de Medicina Intensiva, Departamento de Clínica Médica, Faculdade de Medicina, Hospital de Base, São José do Rio Preto, SP, Brasil.
authors.forename: Suzana Margarete Ajeje
authors.initials: SM
authors.lastname: Lobo
authors.affiliation: Unidade de Terapia Intensiva, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: André Peretti
authors.initials: AP
authors.lastname: Torelly
authors.affiliation: Unidade de Terapia Intensiva, Universidade Estadual do Piauí, Teresina, PI, Brasil.
authors.forename: Patricia Veiga de Carvalho
authors.initials: PV
authors.lastname: Mello
authors.affiliation: Unidade de Terapia Intensiva, Hospital do Câncer de Barretos, Fundação Pio XII, Barretos, SP, Brasil.
authors.forename: Ulisses
authors.initials: U
authors.lastname: Silva
authors.affiliation: Unidade de Terapia Intensiva, Hospital Português, Salvador, BA, Brasil.
authors.forename: José Mário Meira
authors.initials: JM
authors.lastname: Teles
authors.affiliation: Unidade de Terapia Intensiva, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors.forename: Eliézer
authors.initials: E
authors.lastname: Silva
authors.affiliation: Unidade de Terapia Intensiva, Hospital A. C. Camargo, São Paulo, SP, Brasil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Caruso
authors.affiliation: Unidade de Terapia Intensiva, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Friedman
authors.affiliation: Unidade de Terapia Intensiva, Hospital de Clínicas Niterói, Niterói, RJ, Brasil.
authors.forename: Paulo César Pereira de
authors.initials: PC
authors.lastname: Souza
authors.affiliation: Unidade de Terapia Intensiva, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Réa-Neto
authors.affiliation: Unidade de Terapia Intensiva, Hospital A. C. Camargo, São Paulo, SP, Brasil.
authors.forename: Arthur Oswaldo
authors.initials: AO
authors.lastname: Vianna
authors.affiliation: Unidade de Terapia Intensiva, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
authors.forename: José Raimundo
authors.initials: JR
authors.lastname: Azevedo
authors.affiliation: Unidade de Terapia Intensiva, Hospital Unimed Natal, Natal, RN, Brasil.
authors.forename: Erico
authors.initials: E
authors.lastname: Vale
authors.affiliation: Unidade de Terapia Intensiva, Hospital Porto Dias, Belém, PA, Brasil.
authors.forename: Leila
authors.initials: L
authors.lastname: Rezegue
authors.affiliation: Unidade de Terapia Intensiva, Hospital das Clínicas, Universidade Federal de Pernambuco, Pernambuco, PE, Brasil.
authors.forename: Michele
authors.initials: M
authors.lastname: Godoy
authors.affiliation: Unidade de Terapia Intensiva, Hospital Santa Luzia, Brasília, DF, Brasil.
authors.forename: Marcelo Oliveira
authors.initials: MO
authors.lastname: Maia
authors.affiliation: Unidade de Terapia Intensiva, Hospital de Câncer-I, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil.
authors.forename: Jorge Ibrain Figueira
authors.initials: JI
authors.lastname: Salluh