Incidence Of Acute Kidney Injury Among Adult Cancer Patients Receiving Nephrotoxic Chemotherapy At King Abdulaziz University Hospital

Background: Acute kidney injury (AKI) is an acute decrease in renal function that leads to an elevation in the serum blood urea nitrogen, creatinine, and other nitrogenous waste products. Acute kidney injury is a known complication of cancer patients receiving chemotherapy. Aim: To evaluate the occurrence of AKI at King Abdulaziz University Hospital (KAUH) among adult cancer patients undergoing nephrotoxic chemotherapy drugs (Cisplatin, Carboplatin, Cyclophosphamide, and Gemcitabine). Methods: In this retrospective study, medical records of 1229 adult cancer patients were obtained. Of those, 682 were selected based on the use of the drugs chosen for this study, and a total of 767 admissions were included. Acute kidney injury was diagnosed by evidence of an increase in the creatinine level by 0.3 mg/dL or more between two successive cycles. Results: Out of the 767 admissions that were obtained, 58 were found to have AKI. The study included 4 drugs: cisplatin (n=151, 19.7%); carboplatin (n=142, 18.5%); gemcitabine (n=114, 14.9%); cyclophosphamide (n=320, 41.7%); as well as combinations consisting of cisplatin plus gemcitabine (n=22, 2.9%) and carboplatin plus gemcitabine (n=18, 2.3%). The incidences of AKI with each were: cisplatin (n=14, 24.1%, P=0.475); carboplatin (n=7, 12.1%, P=0.255); gemcitabine (n=12, 20.7%, P=0.269); cyclophosphamide (n=19, 32.8%, P=0.193); cisplatin plus gemcitabine (n=5, 8.6%, P=0.020); and carboplatin plus gemcitabine (n=1, 1.7%, P=1.00). Conclusion: Acute kidney injury is more likely to develop if these factors are found; male sex, mean age of 59 or older, using a protocol which includes a combination of cisplatin and gemcitabine, and having a creatinine level above 115 mu mol/L before the first cycle.