• Márcio Soares, Suzana Margarete Ajeje Lobo, André Peretti Torelly, Patricia Veiga de Carvalho Mello, Ulisses Silva, José Mário Meira Teles, Eliézer Silva, Pedro Caruso, Gilberto Friedman, Paulo César Pereira de Souza, Alvaro Réa-Neto, Arthur Oswaldo Vianna, José Raimundo Azevedo, Erico Vale, Leila Rezegue, Michele Godoy, Marcelo Oliveira Maia, Jorge Ibrain Figueira Salluh, and Rede Brasileira de Pesquisa em Terapia Intensiva.
• Unidade de Terapia Intensiva, Hospital de Câncer-I, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil.
• Rev Bras Ter Intensiva. 2010 Sep 1;22(3):236-44.

ObjectivesCritically ill cancer patients are at increased risk for acute kidney injury, but studies on these patients are scarce and were all single centered conducted in specialized intensive care units. The objective was to evaluate the characteristics and outcomes in a prospective cohort of cancer patients admitted to several intensive care units with acute kidney injury.MethodsProspective multicenter cohort study conducted in intensive care units from 28 hospitals in Brazil over a two-month period. Univariate and multivariate logistic regression were used to identify factors associated with hospital mortality.ResultsOut of all 717 intensive care unit admissions, 87 (12%) had acute kidney injury and 36% of them received renal replacement therapy. Kidney injury developed more frequently in patients with hematological malignancies than in patients with solid tumors (26% vs. 11%, P=0.003). Ischemia/shock (76%) and sepsis (67%) were the main contributing factor for and kidney injury was multifactorial in 79% of the patients. Hospital mortality was 71%. General and renal-specific severity-of-illness scores were inaccurate in predicting outcomes for these patients. In a multivariate analysis, length of hospital stay prior to intensive care unit, acute organ dysfunctions, need for mechanical ventilation and a poor performance status were associated with increased mortality. Moreover, cancer-related characteristics were not associated with outcomes.ConclusionsThe present study demonstrates that intensive care units admission and advanced life-support should be considered in selected critically ill cancer patients with kidney injury.

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