Acute Kidney Injury in Patients with Cancer

The review did not mention that diuretics are a major and underestimated cause of nephrotoxicity.2 Diuretics are commonly used in daily practice, despite uncertainties about the benefits except in the context of fluid overload and cardiac dysfunction,3 and are frequently associated with the presence of the tumor lysis syndrome, sepsis,4 and hemodynamic instability.5 We assessed prognostic factors of modified major adverse kidney events at day 30 (MAKE30 -- a composite of death, persistent renal failure, discontinuation of the most effective cancer treatment, and long-term dialysis) in 133 critically ill patients with cancer who were transferred to the intensive care unit and received renal-replacement therapy. Malignant conditions can also be the cause of secondary microangiopathy.1 The most common cancers associated with microangiopathies are gastric, breast, prostate, and lung cancers.2 In the case of prostate cancer, some patients are prone to having a presentation similar to that of the atypical hemolytic-uremic syndrome.3 Furthermore, in patients who have a predisposition to complement dysregulation, cancer has been associated with the occurrence of the atypical hemolytic-uremic syndrome.4 Thus, acute kidney injury caused by microangiopathy should not be seen only as a potential complication of treatments in patients with cancer but also as a specific cancer-related injury. Another distinguishing feature is that patients with cancer-related thrombotic microangiopathy have a leukoerythroblastic blood smear and higher serum lactate dehydrogenase levels than patients who have chemotherapy-associated thrombotic microangiopathy.4,5 It has been speculated that direct vascular endothelial injury (with release of large von Willebrand factor multimers) from the mucin produced by these malignant conditions, as well as circulating tumor cells and tumor emboli, cause thrombotic microangiopathy in this context.4,5 No potential conflict of interest relevant to this letter was reported. 1..

Medienart:	Artikel

Erscheinungsjahr:	2017
Erschienen:	2017

Enthalten in:	Zur Gesamtaufnahme - volume:377
Enthalten in:	The New England journal of medicine - 377(2017), 5, Seite 499

Sprache:	Englisch

Links:	search.proquest.com

BKL:	44.60 44.00
Themen:	Cancer Cancer therapies Kidney Kidney diseases Kidney transplantation Mortality Prevention

RVK:	RVK Klassifikation XA 10000

Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC1998015351