目的:本研究调查肿瘤患者急性肾损伤(AKI)和慢性肾脏病(CKD)的患病率及危险因素,为肿瘤患者的临床治疗提供指导。
方法:对宣武医院收治的所有癌症和血液系统恶性肿瘤患者进行回顾性研究,首都医科大学,从2018年1月到2023年7月。研究人群包括18-80岁确诊为癌症或恶性肿瘤的患者。卡方检验,斯皮尔曼的相关性,和逻辑回归用于评估人口统计学因素之间的关系,合并症,癌症类型,抗肿瘤药物与AKI/CKD的患病率。
结果:在2438名参与者中,AKI和CKD患病率分别为3.69%和7.88%,分别。糖尿病患者的AKI/CKD患病率高于无糖尿病患者(OR=1.66,95%CI1.01-2.68,p=0.040;OR=1.60,95%CI1.10-2.31,p=0.012)。此外,高血压患者CKD患病率较高(OR=3.49,95%CI2.43-5.06,p<0.001).体重过轻的患者更容易发生AKI(OR=2.66,95%CI1.03-6.08,p=0.029)。蒽环类药物可能导致AKI的风险更高,抗代谢物和免疫调节剂可能与CKD的发生发展有关。总的来说,血液系统恶性肿瘤患者的AKI/CKD发生率明显高于实体肿瘤患者.在实体瘤患者中,肺癌和乳腺癌患者的AKI/CKD患病率较低.
结论:AKI和CKD患病率因癌症类型而异,受因素影响,比如糖尿病,高血压,体重,和抗肿瘤药物。量身定制的治疗计划对于改善癌症患者的预后至关重要。
OBJECTIVE: This study investigated the prevalence and risk factors of acute kidney injury (AKI) and chronic kidney disease (CKD) in cancer patients with the aim of providing guidance for clinical treatment of cancer patients.
METHODS: A retrospective study was conducted on all cancer and hematological malignancy patients admitted to Xuanwu Hospital, Capital Medical University, from January 2018 to July 2023. The study population included patients aged 18-80 years with a confirmed cancer or malignancy diagnosis. Chi-square tests, Spearman\'s correlation, and logistic regression were used to evaluate the relationships between demographic factors, comorbidities, cancer types, antitumor drugs and the prevalence of AKI/CKD.
RESULTS: Among the 2438 participants, the prevalence rates of AKI and CKD were 3.69% and 7.88%, respectively. Patients with diabetes had higher prevalence of AKI/CKD than those without diabetes (OR = 1.66, 95% CI 1.01-2.68, p = 0.040; OR = 1.60, 95% CI 1.10-2.31, p = 0.012, respectively). In addition, a higher prevalence of CKD was observed in patients with hypertension (OR = 3.49, 95% CI 2.43-5.06, p < 0.001). Underweight patients were more likely to develop AKI (OR = 2.66, 95% CI 1.03-6.08, p = 0.029). Anthracyclines may contribute to a higher risk of AKI, and antimetabolites and immunomodulators may be associated with the development of CKD. Overall, patients with hematological malignancies had significantly higher rates of AKI/CKD than those with solid tumors. Among solid tumor patients, the prevalence of AKI/CKD was low in patients with lung and breast cancer.
CONCLUSIONS: AKI and CKD prevalence varies across cancer types, influenced by factors, such as diabetes, hypertension, body weight, and antitumor drugs. Tailored treatment plans are essential for improving cancer patient outcomes.