Risk factors for renal alterations in patients with hematological cancer undergoing antineoplastic treatment

Abstract

Purpose Antineoplastic treatments, mainly chemotherapy, affect the kidneys, causing toxicity, and can trigger acute and long-term chronic kidney injury. The objective of this study was to analyze the prevalence of renal disorders in patients with oncohematological neoplasms under antineoplastic treatment. Methods This is a retrospective cohort study involving 75 patients affected by hematological cancer who underwent chemotherapy between 2012 and 2108 in the Hematology Sector of the Walter Cantídeo University Hospital of the Federal University of Ceará. Sociodemographic and clinical data, blood biochemical assessment, and Glomerular Filtration Rate (GFR) were analyzed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The data were tabulated, transferred to the Statistical Package for the Social Sciences software, version 20.0, and analyzed using Fisher's exact test or Pearson's chi-square test, followed by the Mann-Whitney test. Additionally, the variables were treated using a multinomial logistic regression model (p <0.05). Results The prevalence of renal disorders was 52.4%, considering the episodes of GFR through the CKD-EPI equation. There was an association between the reduction in GFR and the variables: female gender (p = 0.002), diagnosis of multiple myeloma (p = 0.008), start of treatment within 40 days (p = 0.005), protocol Cyclophosphamide, Oncovin, Prednisone (p = 0.026), Idarubicin (p = 0.032), Vidaza protocol, Dexamethasone, Cyclophosphamide (p <0.001), Zoledronate (p <0.001) and Pamidronate (p = 0.012). It was also observed that the Cancer and Leukemia Group B protocol (p <0.001) is inversely associated with a reduction in GFR. Conclusions The prevalence of renal disorders is high in the service evaluated, requiring periodic monitoring of the evaluation of renal function, since the reduction in GFR is statistically associated with different protocols used.