Abstract
Acute kidney injury (AKI) is a common complication of cancer that occurs in up to 50% of neoplastic patients during the natural history of their disease; furthermore, it has a huge impact on key outcomes such as overall prognosis, length of hospitalization and costs. AKI in cancer patients has different causes, either patient-, tumour- or treatment-related. Patient-related risk factors for AKI are the same as in the general population, whereas tumour-related risk factors are represented by compression, obstruction, direct kidney infiltration from the tumour as well by precipitation, aggregation, crystallization or misfolding of paraprotein (as in the case of multiple myeloma). Finally, treatment-related risk factors are the most common observed in clinical practice and may present also with the feature of tumour lysis syndrome or thrombotic microangiopathies. In the absence of validated biomarkers, a multidisciplinary clinical approach that incorporates adequate assessment, use of appropriate preventive measures and early intervention is essential to reduce the incidence of this life-threatening condition in cancer patients.
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Details
1 Onco-Nephrology Outpatient Clinic, Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy
2 Department of Biomedical Sciences and Human Oncology, University of Bari ‘A. Moro’, Bari, Italy; Division of Medical Oncology, AOU Consorziale Policlinico di Bari, Bari
3 Nephrology and Dialysis Unit, ASST Cremona, Cremona, Italy
4 Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
5 Division of Medical Oncology, AOU Consorziale Policlinico di Bari, Bari; Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
6 Department of Clinical and Biomedical Sciences ‘Luigi Sacco’, University of Milano, Milan, Italy; Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milan, Italy
7 Department of Translational Medical Sciences, University of Campania ‘L. Vanvitelli’, Naples, Italy; Biogem Research Institute, Ariano Irpino, Italy