Impact of dialysis requirement on outcomes in tumor lysis syndrome.
Tumor lysis syndrome (TLS) is a life threatening emergency due to destruction and massive release of intracellular metabolites from cancer cells often resulting in acute kidney injury (AKI), sometimes severe enough to require dialysis (AKI-D). The impact of dialysis requirement in AKI has not been explored. We utilized data from the Nationwide Inpatient Sample and using International Classification of Diseases, 9th Revision, diagnoses codes for TLS, AKI and dialysis, evaluated the incidence, risk factors and impact of AKI-D on mortality, adverse discharge and length of stay (LOS). Survey multivariable logistic regression was used to compute adjusted Odds Ratios (aOR and 95% confidence intervals (CI). An estimated 12% (2,919) of all TLS hospitalizations (n = 22 875) develop AK-D. After adjustment for confounders, AKI-D was associated with greater odds of mortality (aOR 1.98; (95% CI 1.60-2.45)), adverse discharge (aOR 1.63 (95% CI 1.19-2.24)) and longer LOS (19 vs 14.6 days; P < 0.01) compared with those without AKI-D. Further studies to evaluate the association of AKI-D on long-term outcomes in patients with TLS are needed.
Division of Nephrology, Tufts Medical Center, Boston, MA.
Pranav S
PS
Garimella
Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
Poojitha
P
Balakrishnan
Division of Hematology and Oncology, Indiana University School of Medicine, Indianapolis, IN.
Natraj R
NR
Ammakkanavar
Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Shanti
S
Patel
Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Achint
A
Patel
Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Ioannis
I
Konstantinidis
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
Narender
N
Annapureddy
Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Girish N
GN
Nadkarni
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010351:Patient Discharge; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015275:Tumor Lysis Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D014481:United States
acute kidney injury; dialysis; epidemiology; mortality; outcomes; tumor lysis syndrome