Continuous Renal Replacement Therapy for Acute Renal Failure in Patients with Cancer: A Well-Tolerated Adjunct Treatment

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2016 Aug 19

PMID 27536658

Citations 5

Authors

Rebecca Fischler

Anne-Pascale Meert

Jean-Paul Sculier

Thierry Berghmans

Affiliations

Soon will be listed here.

Abstract

Introduction: Acute renal failure (ARF) has a poor prognosis in patients with cancer requiring intensive care unit (ICU) admission. Our aim is finding prognostic factors for hospital mortality in patients with cancer with ARF requiring renal replacement therapy (RRT).

Methods: In this retrospective study, all patients with cancer with ARF treated with continuous venovenous filtration (CVVHDF) in the ICU of the Institut Jules Bordet, between January 1, 2003 and December 31, 2012, were included.

Results: One hundred and three patients are assessed: men/women 69/34, median age 62 years, solid/hematologic tumors 68/35, median SAPS II 56. Mortality rate was 63%. Seven patients required chronic renal dialysis. After multivariate analysis, two variables were statistically associated with hospital mortality: more than one organ failure (including kidney) (OR 5.918; 95% CI 2.184-16.038; p < 0.001) and low albumin level (OR 3.341; 95% CI 1.229-9.077; p = 0.02). Only minor complications related to CVVHDF have been documented.

Conclusion: Despite the poor prognosis associated with ARF, CVVHDF is an effective and tolerable renal replacement technique in patients with cancer admitted to the ICU. Multiple organ failure and hypoalbuminemia, two independent prognostic factors for hospital mortality have to be considered when deciding for introducing RRT.

Citing Articles

Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy.

Kim D, Jang G, Jung K, Jung H, Kim H, Rhee H Kidney Res Clin Pract. 2022; 41(6):717-729.

PMID: 35977906 PMC: 9731773. DOI: 10.23876/j.krcp.21.305.

The 28-day survive for critically ill cancer patients undergoing continuous renal replacement with postoperative acute kidney injure: a retrospective study of 86 cases.

Yuan Z, Wang H, Qu S, Huang C, Wang H, Zhang H Transl Cancer Res. 2022; 9(10):6221-6231.

PMID: 35117233 PMC: 8798911. DOI: 10.21037/tcr-20-1324.

Critically ill cancer patient's resuscitation: a Belgian/French societies' consensus conference.

Meert A, Wittnebel S, Holbrechts S, Toffart A, Lafitte J, Piagnerelli M Intensive Care Med. 2021; 47(10):1063-1077.

PMID: 34545440 PMC: 8451726. DOI: 10.1007/s00134-021-06508-w.

Absence of Sirt3 aggravates cisplatin nephrotoxicity via enhanced renal tubular apoptosis and inflammation.

Kim D, Park W, Lee S, Kim W, Park S, Kang K Mol Med Rep. 2018; 18(4):3665-3672.

PMID: 30106119 PMC: 6131565. DOI: 10.3892/mmr.2018.9350.

Causal relationship between hypoalbuminemia and acute kidney injury.

Wiedermann C, Wiedermann W, Joannidis M World J Nephrol. 2017; 6(4):176-187.

PMID: 28729966 PMC: 5500455. DOI: 10.5527/wjn.v6.i4.176.

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