Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.

<h4>Background</h4>Optimal chemotherapy with minimal toxicity is the main determinant of complete remission in patients with newly diagnosed hematological malignancies. Acute organ dysfunctions may impair the patient's ability to receive optimal chemotherapy.<h4>Design and met...

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Autores principales:	Emmanuel Canet, Lara Zafrani, Jerome Lambert, Catherine Thieblemont, Lionel Galicier, David Schnell, Emmanuel Raffoux, Etienne Lengline, Sylvie Chevret, Michael Darmon, Elie Azoulay
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/de2d8849a51a4e53a58b04921b808b41
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spelling	oai:doaj.org-article:de2d8849a51a4e53a58b04921b808b412021-11-18T07:57:31ZAcute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.1932-620310.1371/journal.pone.0055870https://doaj.org/article/de2d8849a51a4e53a58b04921b808b412013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23457485/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Optimal chemotherapy with minimal toxicity is the main determinant of complete remission in patients with newly diagnosed hematological malignancies. Acute organ dysfunctions may impair the patient's ability to receive optimal chemotherapy.<h4>Design and methods</h4>To compare 6-month complete remission rates in patients with and without acute kidney injury (AKI), we collected prospective data on 200 patients with newly diagnosed high-grade malignancies (non-Hodgkin lymphoma, 53.5%; acute myeloid leukemia, 29%; acute lymphoblastic leukemia, 11.5%; and Hodgkin disease, 6%).<h4>Results</h4>According to RIFLE criteria, 137 (68.5%) patients had AKI. Five causes of AKI accounted for 91.4% of cases: hypoperfusion, tumor lysis syndrome, tubular necrosis, nephrotoxic agents, and hemophagocytic lymphohistiocytosis. Half of the AKI patients received renal replacement therapy and 14.6% received suboptimal chemotherapy. AKI was associated with a lower 6-month complete remission rate (39.4% vs. 68.3%, P<0.01) and a higher mortality rate (47.4% vs. 30.2%, P<0.01) than patients without AKI. By multivariate analysis, independent determinants of 6-month complete remission were older age, poor performance status, number of organ dysfunctions, and AKI.<h4>Conclusion</h4>AKI is common in patients with newly diagnosed high-grade malignancies and is associated with lower complete remission rates and higher mortality.Emmanuel CanetLara ZafraniJerome LambertCatherine ThieblemontLionel GalicierDavid SchnellEmmanuel RaffouxEtienne LenglineSylvie ChevretMichael DarmonElie AzoulayPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 2, p e55870 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Emmanuel Canet Lara Zafrani Jerome Lambert Catherine Thieblemont Lionel Galicier David Schnell Emmanuel Raffoux Etienne Lengline Sylvie Chevret Michael Darmon Elie Azoulay Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.
description	<h4>Background</h4>Optimal chemotherapy with minimal toxicity is the main determinant of complete remission in patients with newly diagnosed hematological malignancies. Acute organ dysfunctions may impair the patient's ability to receive optimal chemotherapy.<h4>Design and methods</h4>To compare 6-month complete remission rates in patients with and without acute kidney injury (AKI), we collected prospective data on 200 patients with newly diagnosed high-grade malignancies (non-Hodgkin lymphoma, 53.5%; acute myeloid leukemia, 29%; acute lymphoblastic leukemia, 11.5%; and Hodgkin disease, 6%).<h4>Results</h4>According to RIFLE criteria, 137 (68.5%) patients had AKI. Five causes of AKI accounted for 91.4% of cases: hypoperfusion, tumor lysis syndrome, tubular necrosis, nephrotoxic agents, and hemophagocytic lymphohistiocytosis. Half of the AKI patients received renal replacement therapy and 14.6% received suboptimal chemotherapy. AKI was associated with a lower 6-month complete remission rate (39.4% vs. 68.3%, P<0.01) and a higher mortality rate (47.4% vs. 30.2%, P<0.01) than patients without AKI. By multivariate analysis, independent determinants of 6-month complete remission were older age, poor performance status, number of organ dysfunctions, and AKI.<h4>Conclusion</h4>AKI is common in patients with newly diagnosed high-grade malignancies and is associated with lower complete remission rates and higher mortality.
format	article
author	Emmanuel Canet Lara Zafrani Jerome Lambert Catherine Thieblemont Lionel Galicier David Schnell Emmanuel Raffoux Etienne Lengline Sylvie Chevret Michael Darmon Elie Azoulay
author_facet	Emmanuel Canet Lara Zafrani Jerome Lambert Catherine Thieblemont Lionel Galicier David Schnell Emmanuel Raffoux Etienne Lengline Sylvie Chevret Michael Darmon Elie Azoulay
author_sort	Emmanuel Canet
title	Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.
title_short	Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.
title_full	Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.
title_fullStr	Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.
title_full_unstemmed	Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.
title_sort	acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/de2d8849a51a4e53a58b04921b808b41
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Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.

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