Cystatin C level is associated with the recovery of renal function in cancer patients after onset of acute kidney injury.

Abstract

The risk of injury to the kidney can be significantly exacerbated by the presence of tumors and the effects of related treatments. Kidney injury associated with cancer is common in multiple myeloma, tumor lysis syndrome, hematopoietic stem cell therapy, and chemotherapy. Cancer patients are at increased risk of infection, sepsis, tumor lysis syndrome, drug-related toxicity, and other comorbidities, leading to a significantly increased risk of acute kidney injury (AKI). This study retrospectively analyzed the clinical data of AKI in cancer patients and explored the predictive value of Cystatin C (CysC) in the prognosis of cancer patients with AKI. Cancer patients attending the Fifth People's Hospital of Shenyang from April 2014 to March 2019 were enrolled according to inclusion and exclusion criteria. Cancer patients with AKI were divided into two groups according to the changes in renal function during the follow-up period: a renal function recovery group and a nonrecovery group. The differences in baseline data of the two groups were compared. Logistic univariate and multivariate regression analyses were conducted to determine the risk of renal function failure. A total of 3,127 cases were included. Among them, 659 cases (21.1%) had AKI, and 2,468 cases had no AKI. Among the 659 AKI patients, 473 (71.8%) patients' renal function recovered, while 186 (28.2%) did not. Logistic univariate and multivariate regression analyses indicated that age [odds ratio (OR) =1.133, 95% confidence interval (CI): 1.064-1.219], diabetes (OR =1.226, 95% CI: 1.093-1.385), chronic kidney disease (CKD) (OR =1.347, 95% CI: 1.108-1.624), hematological malignancies (OR =1.174, 95% CI: 1.063-1.311), chemotherapy (OR =1.119, 95% CI: 1.055-1.304), systolic blood pressure (OR =1.108, 95% CI: 1.062-1.267), serum creatinine (Scr) (OR =1.262, 95% CI: 1.105-1.446), and CysC (OR =1.416, 95% CI: 1.251-1.739) were related to the failure of renal function to recover after AKI. Baseline CysC level is associated with the occurrence of AKI in cancer patients and a failure to recover renal function during follow-up.