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What are the Common causes of AKI in cancer patients?
The below table summarizes the pre-renal, intrinsic, and post-renal causes of AKI in the cancer patient.
Pre renal, Intrinsic and Post renal Causes of Acute Kidney Injury in the Cancer Patient
| PRE-RENAL | INTRINSIC | POST-RENAL |
|---|---|---|
| Kidney hypo-perfusion due to sepsis, ascites, and effusions Volume depletion (↓ oral intake, diarrhea, over-diuresis) Impaired cardiac output Hepatic sinusoid obstructive syndrome Hypercalcemia Non-chemotherapeutic drugs (NSAIDS, ACEi/ARB, calcineurin inhibitors) Capillary leak syndrome (e.g., due to IL2, CAR-T therapy) | Acute tubular necrosis due to• Protracted ischemia• Nephrotoxic agents: for example, IV contrast,• Ifosfamide, cisplatin, aminoglycoside Lymphomatous infiltration of the kidney Acute interstitial nephritis Tumor lysis syndrome Cast nephropathy Thrombotic microangiopathy Calcineurin inhibitor toxicity | Obstruction due to• Primary or metastatic abdominal or pelvic malignancy• Retroperitoneal fibrosis• Crystals (Acyclovir, urate, methotrexate) |
ACEi , Angiotensin converting enzyme inhibitor; ARB , angiotensin receptor blocker; CAR-T , chimeric antigen receptor–T-cell therapy; IL , interleukin; IV , intravenous; NSAIDS , non-steroidal anti-inflammatory drugs.
