Acute kidney injury adversely affects the clinical course of acute myeloid leukemia patients undergoing induction chemotherapy
Acute kidney injury (AKI) complicates the clinical course of hospitalized patients by increasing need for intensive care treatment and mortality. There is only little data about its impact on AML patients undergoing intensive induction chemotherapy. In this study, we analyzed the incidence as well a...
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| Veröffentlicht in: | Annals of hematology 2021-05, Vol.100 (5), p.1159-1167 |
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| creator | Ballo, Olivier Eladly, Fagr Büttner, Stefan Stratmann, Jan Alexander Rudolf, Sarah Brunnberg, Uta Kreisel, Eva-Maria Steffen, Björn Wagner, Sebastian Finkelmeier, Fabian Serve, Hubert Brandts, Christian H. |
| description | Acute kidney injury (AKI) complicates the clinical course of hospitalized patients by increasing need for intensive care treatment and mortality. There is only little data about its impact on AML patients undergoing intensive induction chemotherapy. In this study, we analyzed the incidence as well as risk factors for AKI development and its impact on the clinical course of AML patients undergoing induction chemotherapy. We retrospectively analyzed data from 401 AML patients undergoing induction chemotherapy between 2007 and 2019. AKI was defined and stratified according to KIDGO criteria by referring to a defined baseline serum creatinine measured on day 1 of induction chemotherapy. Seventy-two of 401 (18%) AML patients suffered from AKI during induction chemotherapy. AML patients with AKI had more days with fever (7 vs. 5,
p
= 0.028) and were more often treated on intensive care unit (45.8% vs. 10.6%,
p
< 0.001). AML patients with AKI had a significantly lower complete remission rate after induction chemotherapy and, with 402 days, a significantly shorter median overall survival (OS) (median OS for AML patients without AKI not reached). In this study, we demonstrate that the KIDGO classification allows mortality risk stratification for AML patients undergoing induction chemotherapy. Relatively mild AKI episodes have impact on the clinical course of these patients and can lead to chronic impairment of kidney function. Therefore, we recommend incorporating risk factors for AKI in decision-making considering nutrition, fluid management, as well as the choice of potentially nephrotoxic medication in order to decrease the incidence of AKI. |
| doi_str_mv | 10.1007/s00277-021-04482-3 |
| format | Article |
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p
= 0.028) and were more often treated on intensive care unit (45.8% vs. 10.6%,
p
< 0.001). AML patients with AKI had a significantly lower complete remission rate after induction chemotherapy and, with 402 days, a significantly shorter median overall survival (OS) (median OS for AML patients without AKI not reached). In this study, we demonstrate that the KIDGO classification allows mortality risk stratification for AML patients undergoing induction chemotherapy. Relatively mild AKI episodes have impact on the clinical course of these patients and can lead to chronic impairment of kidney function. Therefore, we recommend incorporating risk factors for AKI in decision-making considering nutrition, fluid management, as well as the choice of potentially nephrotoxic medication in order to decrease the incidence of AKI.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-021-04482-3</identifier><identifier>PMID: 33704529</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acute Kidney Injury - etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chemotherapy ; Female ; Hematology ; Humans ; Induction Chemotherapy - adverse effects ; Intensive care ; Kidneys ; Leukemia, Myeloid, Acute - complications ; Leukemia, Myeloid, Acute - drug therapy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Original ; Original Article ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult</subject><ispartof>Annals of hematology, 2021-05, Vol.100 (5), p.1159-1167</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-51f0eff822e6cd092a289bbd8680a3ef9da43e81613b3d1f1119d32d54a74fa13</citedby><cites>FETCH-LOGICAL-c540t-51f0eff822e6cd092a289bbd8680a3ef9da43e81613b3d1f1119d32d54a74fa13</cites><orcidid>0000-0003-1634-1988</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-021-04482-3$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-021-04482-3$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33704529$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ballo, Olivier</creatorcontrib><creatorcontrib>Eladly, Fagr</creatorcontrib><creatorcontrib>Büttner, Stefan</creatorcontrib><creatorcontrib>Stratmann, Jan Alexander</creatorcontrib><creatorcontrib>Rudolf, Sarah</creatorcontrib><creatorcontrib>Brunnberg, Uta</creatorcontrib><creatorcontrib>Kreisel, Eva-Maria</creatorcontrib><creatorcontrib>Steffen, Björn</creatorcontrib><creatorcontrib>Wagner, Sebastian</creatorcontrib><creatorcontrib>Finkelmeier, Fabian</creatorcontrib><creatorcontrib>Serve, Hubert</creatorcontrib><creatorcontrib>Brandts, Christian H.</creatorcontrib><title>Acute kidney injury adversely affects the clinical course of acute myeloid leukemia patients undergoing induction chemotherapy</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><addtitle>Ann Hematol</addtitle><description>Acute kidney injury (AKI) complicates the clinical course of hospitalized patients by increasing need for intensive care treatment and mortality. There is only little data about its impact on AML patients undergoing intensive induction chemotherapy. In this study, we analyzed the incidence as well as risk factors for AKI development and its impact on the clinical course of AML patients undergoing induction chemotherapy. We retrospectively analyzed data from 401 AML patients undergoing induction chemotherapy between 2007 and 2019. AKI was defined and stratified according to KIDGO criteria by referring to a defined baseline serum creatinine measured on day 1 of induction chemotherapy. Seventy-two of 401 (18%) AML patients suffered from AKI during induction chemotherapy. AML patients with AKI had more days with fever (7 vs. 5,
p
= 0.028) and were more often treated on intensive care unit (45.8% vs. 10.6%,
p
< 0.001). AML patients with AKI had a significantly lower complete remission rate after induction chemotherapy and, with 402 days, a significantly shorter median overall survival (OS) (median OS for AML patients without AKI not reached). In this study, we demonstrate that the KIDGO classification allows mortality risk stratification for AML patients undergoing induction chemotherapy. Relatively mild AKI episodes have impact on the clinical course of these patients and can lead to chronic impairment of kidney function. Therefore, we recommend incorporating risk factors for AKI in decision-making considering nutrition, fluid management, as well as the choice of potentially nephrotoxic medication in order to decrease the incidence of AKI.</description><subject>Acute Kidney Injury - etiology</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Chemotherapy</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>Induction Chemotherapy - adverse effects</subject><subject>Intensive care</subject><subject>Kidneys</subject><subject>Leukemia, Myeloid, Acute - complications</subject><subject>Leukemia, Myeloid, Acute - drug therapy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0939-5555</issn><issn>1432-0584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtv1DAUhS1ERYeWP8ACWWIduH5k4myQqoqXVIlNu7Y89vWMp4k92EmlbPrbcTulwAZvbOmc890rH0LeMvjAALqPBYB3XQOcNSCl4o14QVZMCt5Aq-RLsoJe9E1bzyl5XcoegHEl-StyKkQHsuX9itxf2HlCehtcxIWGuJ_zQo27w1xwqC_v0U6FTjukdggxWDNQm-aq0uSpeQyPCw4pODrgfItjMPRgpoCxxuboMG9TiNuKdrOdQorU7nBMFZjNYTknJ94MBd883Wfk5svn68tvzdWPr98vL64a20qYmpZ5QO8V57i2DnpuuOo3G6fWCoxA3zsjBSq2ZmIjHPOMsd4J7lppOukNE2fk05F7mDcjOlu3y2bQhxxGkxedTND_KjHs9DbdaQVS9Bwq4P0TIKefM5ZJ7-svxLqz5i3jbA0tiOriR5fNqZSM_nkCA_3QmT52pmtn-rEz_RB69_duz5HfJVWDOBpKleIW85_Z_8H-AnK4pjk</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Ballo, Olivier</creator><creator>Eladly, Fagr</creator><creator>Büttner, Stefan</creator><creator>Stratmann, Jan Alexander</creator><creator>Rudolf, Sarah</creator><creator>Brunnberg, Uta</creator><creator>Kreisel, Eva-Maria</creator><creator>Steffen, Björn</creator><creator>Wagner, Sebastian</creator><creator>Finkelmeier, Fabian</creator><creator>Serve, Hubert</creator><creator>Brandts, Christian H.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1634-1988</orcidid></search><sort><creationdate>20210501</creationdate><title>Acute kidney injury adversely affects the clinical course of acute myeloid leukemia patients undergoing induction chemotherapy</title><author>Ballo, Olivier ; 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There is only little data about its impact on AML patients undergoing intensive induction chemotherapy. In this study, we analyzed the incidence as well as risk factors for AKI development and its impact on the clinical course of AML patients undergoing induction chemotherapy. We retrospectively analyzed data from 401 AML patients undergoing induction chemotherapy between 2007 and 2019. AKI was defined and stratified according to KIDGO criteria by referring to a defined baseline serum creatinine measured on day 1 of induction chemotherapy. Seventy-two of 401 (18%) AML patients suffered from AKI during induction chemotherapy. AML patients with AKI had more days with fever (7 vs. 5,
p
= 0.028) and were more often treated on intensive care unit (45.8% vs. 10.6%,
p
< 0.001). AML patients with AKI had a significantly lower complete remission rate after induction chemotherapy and, with 402 days, a significantly shorter median overall survival (OS) (median OS for AML patients without AKI not reached). In this study, we demonstrate that the KIDGO classification allows mortality risk stratification for AML patients undergoing induction chemotherapy. Relatively mild AKI episodes have impact on the clinical course of these patients and can lead to chronic impairment of kidney function. Therefore, we recommend incorporating risk factors for AKI in decision-making considering nutrition, fluid management, as well as the choice of potentially nephrotoxic medication in order to decrease the incidence of AKI.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33704529</pmid><doi>10.1007/s00277-021-04482-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1634-1988</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Kidney Injury - etiology Adolescent Adult Aged Aged, 80 and over Chemotherapy Female Hematology Humans Induction Chemotherapy - adverse effects Intensive care Kidneys Leukemia, Myeloid, Acute - complications Leukemia, Myeloid, Acute - drug therapy Male Medicine Medicine & Public Health Middle Aged Oncology Original Original Article Retrospective Studies Risk Factors Treatment Outcome Young Adult |
| title | Acute kidney injury adversely affects the clinical course of acute myeloid leukemia patients undergoing induction chemotherapy |
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