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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2020.1010    [Accepted]
Clinical Significance of Acute Kidney Injury in Lung Cancer Patients
Semin Cho1, Eunjeong Kang2, Ji Eun Kim3, U Kang4, Hee Gyung Kang5, Minsu Park6, Kwangsoo Kim7, Dong Ki Kim1, Kwon Wook Joo1, Yon Su Kim1, Hyung-Jin Yoon8,9, Hajeong Lee1
1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
2Department of Internal Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
3Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
4Department of Computer Science and Engineering, Seoul National University College of Engineering, Seoul, Korea
5Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
6Department of Statistics, Keimyung University, Daegu, Korea
7Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, Korea
8Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
9Department of Biomedical Engineering, Seoul National University, Seoul, Korea
Correspondence  Hyung-Jin Yoon ,Tel: 82-2-2072-7516, Fax: 82-2-762-9662, Email: hjyoon@snu.ac.kr
Hajeong Lee ,Tel: 82-2-2072-4905 , Fax: 82-2-762-9662, Email: mdhjlee@gmail.com
Received: October 5, 2020;  Accepted: January 17, 2021.  Published online: January 18, 2021.
ABSTRACT
Purpose
Acute kidney injury (AKI) in cancer patients is associated with increased morbidity and mortality. The incidence of AKI in lung cancer seems to be relatively higher compared with other solid organ malignancies, although its impact on patient outcomes remains unclear.
Materials and Methods
The patients newly diagnosed with lung cancer from 2004 to 2013 were enrolled in this retrospective cohort study. The patients were categorized according to the presence and severity of AKI. We compared all-cause mortality and long-term renal outcome according to AKI stage.
Results
A total of 3,202 patients were included in the final analysis. AKI occurred in 1,783 (55.7%) patients during the follow-up period, with the majority having mild AKI stage 1 (75.8%). During the follow-up of 2.6 ± 2.18 years, total 1,251 (53.7%) patients were died and 5-yr survival rate was 46.9%. We found that both AKI development and severity were independent risk factors for all-cause mortality in lung cancer patients, even after adjustment for lung cancer-specific variables including the stage or pathological type. In addition, patients suffered from more severe AKI tend to encounter de novo CKD development, worsening kidney function, and end-stage kidney disease progression.
Conclusion
In this study, more than half of the lung cancer patients experienced AKI during their diagnosis and treatment period. Moreover, AKI occurrence and more advanced AKI were associated with a higher mortality risk and adverse kidney outcomes.
Key words: Acute kidney injury, Lung neoplasms, Onco-nephrology, All-cause mortality, Long-term kidney outcome
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