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An AKI project for critically ill cancer patients

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Presentation on theme: "An AKI project for critically ill cancer patients"— Presentation transcript:

1 An AKI project for critically ill cancer patients
Peter Pickkers Department of Intensive Care Medicine Radboud university medical centre, Nijmegen Paris, March 28th 2017

2

3 Remaining questions Difference in AKI kinetics per cause of AKI
(cancer patients different from the ‘regular’ critically ill patient) Effect of transition to other AKI severity category on outcome Outcome AKI vs patients admitted with Chronic Renal Failure Changes in ICU admission policy Role of biomarkers?

4 Evolution of acute kidney injury

5 Evolution of acute kidney injury

6 Evolution of acute kidney injury

7 Evolution of acute kidney injury

8 Hospital mortality

9 Hospital mortality Recovery from AKI-F: 15-20% lower mortality

10 Hospital mortality Recovery from AKI-F: 15-20% lower mortality

11 Hospital mortality Recovery from AKI-F: 15-20% lower mortality
However, still twice as high as patients with No-AKI at all

12

13 Baseline demographics
Age Male sex Comorbidities Cause underlying immune suppression High BMI Diabetes Chronic liver disease Chronic heart disease Chronic kidney impairment Creatinine, baseline  

14 Aetiological risk factors
Dehydration Hypotension or shock Cardiac Liver Acute kidney disease Urinary obstruction Infection, sepsis Systemic diseases Nephrotoxic agents

15 Other organ failures at acute kidney injury confirmation day
Pulmonary Cardiovascular Neurological Hepatic Haematological None Number of organ failures: 0, 1, 2, 3

16 At acute kidney injury diagnosis
sCr (μmol/L) BUN (mmol/L) Urine output past 24 h (mL) Criteria for acute kidney injury diagnosis sCr (alone) Oliguria (alone) sCr and urine output Stage at diagnosis (1, 2, 3) Biomarkers?

17 Multivariate analyses that determines renal and clinical outcome in these patients, including
Age Hospital-acquired acute kidney injury Number of organ failures Sepsis Use of antibiotics Oliguria Chronic kidney disease Need for dialysis Limitations of treatment, including RRT

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