TY - CHAP
T1 - Acute kidney injury incidence, pathogenesis, and outcomes
AU - Lahoti, Amit
AU - Chen, Sheldon
N1 - Publisher Copyright:
© 2020 Elsevier Inc. All rights reserved.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Acute kidney injury (AKI) remains a common complication of cancer treatment and entails increased length of stay, cost, and mortality. The etiology of AKI may be direct injury from the underlying malignancy, drug toxicity, related to stem cell transplant, or from treatment complications. Advances in immunotherapy and targeted therapy have also highlighted the nephrotoxic potential of many of these drugs. Patients with liquid tumors (leukemia, lymphoma, myeloma) have the highest incidence of AKI, especially in the critical care setting. Although AKI does tend to improve in survivors, renal recovery is less likely with more severe grade of AKI. Baseline chronic kidney disease also confers an increased risk of AKI during cancer treatment. Although cancer itself is not a contraindication for starting renal replacement therapy (RRT), the benefits of RRT must be weighed against the overall prognosis of the patient and quality of life. A multidisciplinary discussion between the patient, nephrologist, oncologist, intensivist, and palliative care physician is often necessary to make an informed clinical decision.
AB - Acute kidney injury (AKI) remains a common complication of cancer treatment and entails increased length of stay, cost, and mortality. The etiology of AKI may be direct injury from the underlying malignancy, drug toxicity, related to stem cell transplant, or from treatment complications. Advances in immunotherapy and targeted therapy have also highlighted the nephrotoxic potential of many of these drugs. Patients with liquid tumors (leukemia, lymphoma, myeloma) have the highest incidence of AKI, especially in the critical care setting. Although AKI does tend to improve in survivors, renal recovery is less likely with more severe grade of AKI. Baseline chronic kidney disease also confers an increased risk of AKI during cancer treatment. Although cancer itself is not a contraindication for starting renal replacement therapy (RRT), the benefits of RRT must be weighed against the overall prognosis of the patient and quality of life. A multidisciplinary discussion between the patient, nephrologist, oncologist, intensivist, and palliative care physician is often necessary to make an informed clinical decision.
KW - Acute kidney injury
KW - Cancer
KW - Critical care
KW - Immunotherapy
KW - Targeted therapy
UR - http://www.scopus.com/inward/record.url?scp=85093495621&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85093495621&partnerID=8YFLogxK
U2 - 10.1016/B978-0-323-54945-5.00038-2
DO - 10.1016/B978-0-323-54945-5.00038-2
M3 - Chapter
AN - SCOPUS:85093495621
SN - 9780323549615
SP - 269-274.e3
BT - Onco-Nephrology
PB - Elsevier
ER -