Introduction: The treatment of cancer has undergone significant advances in recent times. Despite the advantages that chemotherapeutics provide for different malignancies, nephrotoxicity remains a complication, and sometimes limits life-saving therapy. Acute kidney injury (AKI) continues to be a major concern in cancer patients. It is related to many contributory factors including cancer-related and patient-specific factors as well as chemotherapy-related renal toxicity, which negatively impact the outcome in managing cancer patients.
Objectives: assessing the incidence of AKI in cancer patients at Najah National university hospital (NNUH) in the years 2016-2017, as well as the demographics and clinical characteristics of patients in relation to the risk of AKI.
Methods: A Retrospective cohort study was conducted at Najah National University Hospital in the period 2016-2017. A data abstraction sheet was used to collect related variables using computerized data from registration forms completed by physicians in addition to laboratory, pathology, and radiology departments after ethical approval from the Institutional Review Board (IRB) at Najah National University was obtained.
Results: Using RIFLE (Risk, Injury, Failure, Loss and End stage renal disease) criteria, 6.9% admissions were complicated with AKI. The severity of these fell into the categories of the Risk, Injury and Failure; 3.3%, 1.7% and 1.9% respectively. In the multivariate model, the odds ratio for developing AKI was significantly higher for patients with congestive heart failure, chronic kidney disease, sepsis and ICU admissions. The odds for mortality (5.673 fold) were significantly greater among AKI patients.
Conclusion: The rate of AKI in patients admitted to NNUH was correlated significantly with congestive heart failure, chronic kidney disease, sepsis and ICU admission, which contributed to worse outcomes and higher mortality rates.
Recommendations: Creatinine evaluation should be done upon admission and discharge for every cancer patient admitted to the hospital, especially for those who have risk factors that play a major role in the development of AKI. Doctors should seek any evidence of AKI by using RIFLE criteria early on as minor changes can be detected at the risk category.