Assessing the Risk: The Susceptibility of a Cancer Patient to Acute Kidney Injury

By Riya Gandhi ‘22

kidney.jpg
Figure 1. Although acute kidney injury mainly indicates kidney damage, it can also affect the brain and other organs, making it a deadly condition.

Due to their ability to purify blood and remove wastes, the kidneys are regarded as the filtration system for the human body. As such, they are one of the most crucial organs. However, what happens one or both of your kidneys are damaged, or worse, fail completely? Such an occurrence is known as acute kidney injury (AKI) and can transpire within a few days or even within a few hours. Although the elderly have a large risk of acute kidney injury, a survey conducted in China reveals that cancer patients may also be one of the more susceptible populations.

Dr. Juan Jin and his team of scientists from Zhejiang Provincial People’s Hospital in China administered a nationwide survey in hospitals to assess risk factors for malignancy-related AKI (MR-AKI). Approximately 374, 286 hospitalized adults were surveyed. First, the researchers inspected medical records of 7.604 known AKI cases, noting that 18.6% were characteristic of MR-AKI. These 1,418 patients were separated into those who were known to have AKI according to the AKI serum creatinine (SCr) criteria and those who were recognized as having the same condition according to an expanded criteria. In doing so, they discovered that more than half of these cases were ones in which AKI had developed in the hospital setting, while others were acquired in the community. Furthermore, MR-AKI was more common in academic hospitals rather than local hospitals. It was also more prevalent in mid-China, rather than the north or south. Researchers reasoned that this difference in detection may be due to income discrepancies and economic development differences in these regions. Additional analysis revealed that gastrointestinal cancer was the malignancy in almost half of the 1,418 patients, followed by reproductive system cancer, haematological cancer, respiratory system cancer, and other cancers. Male patients who had cancer were more likely than females of the same condition to develop MR-AKI. Although in-hospital mortality was found to be 18.9%, researchers believe that this may be less than the actual value as deaths after discharge were not taken into consideration.

Despite having been limited to one region in the world, this survey nonetheless provides us with more insight regarding the correlation between cancer and acute kidney injury. From the aforementioned data collected, the scientists were able to conclude that AKI is a prevalent condition among hospitalized cancer patients that may be increasing due to current aggressive cancer therapies. If this study were implemented on a global level, the information collected could lead to greater priority of decreasing the risk of AKI among cancer patients.
References

  1. J. Jin, et. al., Acute kidney injury in cancer patients: A nationwide survey in China. Nature, (2019). doi: 10.1038/s41598-019-39735-9.  
  2. Image retrieved from: https://www.pexels.com/photo/grayscale-photo-of-man-1573823/
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