Impact of dialysis requirement on outcomes in tumor lysis syndrome |
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| Authors: | Pranav S. Garimella Poojitha Balakrishnan Natraj R. Ammakkanavar Shanti Patel Achint Patel Ioannis Konstantinidis Narender Annapureddy Girish N. Nadkarni |
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| Affiliation: | 1. Division of Nephrology, Tufts Medical Center, Boston, MA;2. Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD;3. Division of Hematology and Oncology, Indiana University School of Medicine, Indianapolis, IN;4. Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY;5. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN |
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| Abstract: | Tumor lysis syndrome (TLS) is a life threatening emergency due to destruction and massive release of intracellular metabolites from cancer cells often resulting in acute kidney injury (AKI), sometimes severe enough to require dialysis (AKI‐D). The impact of dialysis requirement in AKI has not been explored. We utilized data from the Nationwide Inpatient Sample and using International Classification of Diseases, 9th Revision, diagnoses codes for TLS, AKI and dialysis, evaluated the incidence, risk factors and impact of AKI‐D on mortality, adverse discharge and length of stay (LOS). Survey multivariable logistic regression was used to compute adjusted Odds Ratios (aOR and 95% confidence intervals (CI). An estimated 12% (2,919) of all TLS hospitalizations (n = 22 875) develop AK‐D. After adjustment for confounders, AKI‐D was associated with greater odds of mortality (aOR 1.98; (95% CI 1.60–2.45)), adverse discharge (aOR 1.63 (95% CI 1.19–2.24)) and longer LOS (19 vs 14.6 days; P < 0.01) compared with those without AKI‐D. Further studies to evaluate the association of AKI‐D on long‐term outcomes in patients with TLS are needed. |
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| Keywords: | acute kidney injury dialysis epidemiology mortality outcomes tumor lysis syndrome |
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