title: Acute kidney injury in critically ill patients with haematological malignancies: results of a multicentre cohort study from the Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologie.
abstract: BACKGROUND
  Cancer patients are at high risk for acute kidney injury (AKI), which is associated with high morbidity and mortality. We sought to appraise the incidence, risk factors, and outcome of AKI in a large multicentre cohort study of critically ill patients with haematological malignancies.
  
  
  METHODS
  We used a retrospective analysis of a prospectively collected database. The study was carried out in 17 university or university-affiliated centres in France and Belgium between 2010 and 2012. AKI was defined according to the Acute Kidney Injury Network (AKIN) definition.
  
  
  RESULTS
  Of the 1011 patients admitted into the intensive care unit (ICU) during the study period, 1009 were included in this study. According to the AKIN definition, 671 patients (66.5%) developed an AKI during their ICU stay, of which 258 patients (38.4%) were AKI stage 1, 75 patients (11.2%) AKI stage 2 and 338 patients (50.4%) AKI stage 3. After adjustment for confounders, main adverse risk factors of AKI were older age, severity [non-renal Sequential Organ Failure Assessment (SOFA)], history of hypertension, tumour lysis syndrome, exposure to nephrotoxic agents and myeloma. Hospital mortality was 44.3% in patients with AKI and 25.4% in patients without AKI (P < 0.0001). After adjustment for confounders, AKI was independently associated with hospital mortality [OR 1.65 (95% CI 1.19-2.29)]. Overall, 271 patients required renal replacement therapy (RRT), of whom 57.2% died during their hospital stay as compared with 31.2% (P < 0.0001) in those not requiring RRT.
  
  
  CONCLUSIONS
  Two-thirds of critically ill patients with haematological malignancies developed AKI. Hospital mortality in this population of patients developing AKI or requiring RRT is close to that in general ICU population.
authors.affiliation: University Hospital, Saint-Etienne, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Darmon
authors.affiliation: Avicenne University Hospital, Bobigny, France.
authors.forename: François
authors.initials: F
authors.lastname: Vincent
authors.affiliation: Saint-Louis University Hospital, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Canet
authors.affiliation: Paoli Calmette Institute, Marseille, France.
authors.forename: Djamel
authors.initials: D
authors.lastname: Mokart
authors.affiliation: Cochin University Hospital, Paris France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Pène
authors.affiliation: University Hospital, Angers, France.
authors.forename: Achille
authors.initials: A
authors.lastname: Kouatchet
authors.affiliation: Pitié-Salpétrière University Hospital, Paris, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Mayaux
authors.affiliation: Victor Provo Hospital, Roubaix, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Nyunga
authors.affiliation: Mignot Hospital, Versailles, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bruneel
authors.affiliation: Cochin University Hospital, Paris France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Rabbat
authors.affiliation: Montaigu Hospital, La Roche-sur-Yon, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Lebert
authors.affiliation: Brabois University Hospital, Nancy, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Perez
authors.affiliation: Brest University Hospital, Brest, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Renault
authors.affiliation: Jules Bordet Institute, Brussels, Belgium.
authors.forename: Anne-Pascale
authors.initials: AP
authors.lastname: Meert
authors.affiliation: Ghent University Hospital, Ghent, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Benoit
authors.affiliation: Albert Michallon University Hospital, Grenoble, France.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hamidfar
authors.affiliation: Salengro University Hospital, Lille, France.
authors.forename: Mercé
authors.initials: M
authors.lastname: Jourdain
authors.affiliation: Saint-Louis University Hospital, Paris, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Schlemmer
authors.affiliation: Saint-Louis University Hospital, Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.affiliation: Saint-Louis University Hospital, Paris, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Lemiale
authors.affiliation: Saint-Louis University Hospital, Paris, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Azoulay
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D016022:Case-Control Studies; D016638:Critical Illness; D016208:Databases, Factual; D005260:Female; D005602:France / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000150:complications*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: ICU; acute kidney injury; prognosis; renal replacement therapy; tumour lysis syndrome