Abstract

COELHO, Inês et al. In-hospital and one-year mortality among patients with acute kidney injury and hematological malignancies. Port J Nephrol Hypert [online]. 2021, vol.35, n.1, pp.11-17.  Epub Mar 31, 2021. ISSN 0872-0169.  https://doi.org/10.32932/pjnh.2021.04.111.

Hematological malignancies (HM) confer a high risk of acute kidney injury (AKI), which is associated with elevated morbi-mortality. The aim of this study was to identify the prognostic factors for in-hospital mortality and one-year mortality in this population. We conducted a single center, retrospective, observational cohort study of 101 in-hospital patients with AKI and HM between January 2015 and December 2019. Multiple myeloma was present in 30.7% of the patients, followed by non-Hodgkin lymphoma (NHL) in 27.7%. Renal support therapy (RST) was needed in 60.4% of the cases. Independent predictors for in-hospital mortality were invasive mechanical ventilation (IMV) (OR 49.53; 95% CI:9.17 - 267.57; P<0.001) and infection during in-hospital stay (IDHS) (OR 5.09; 95% CI:1.18 - 21.89; P=0.029). Predictors for one-year mortality were NHL (HR 2.88; 95% CI:1.54 - 5.39; P=0.001), tumor progression (HR 2.36; 95% CI:1.29 - 4.32; P=0.006) and IMV (HR 6.38; 95% CI:3.50 - 11.64; P<0.001). Higher albumin levels at AKI diagnosis conferred a better prognosis (HR 0.57; 95% CI:0.35 - 0.91; P=0.020). Our model showed that patients with HM and AKI who were submitted to IMV and had IDHS had a probability of in-hospital death of 96%. Albumin at the time of AKI influenced one-year mortality.

Keywords : Acute kidney injury; hematologic malignancies; hemodialysis; intensive care; prognosis; risk factors.

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