SP277ACUTE RENAL FAILURE IN ONCOHAEMATOLOGICAL PATIENTS

Abstract

Introduction and Aims: Acute renal failure (ARF) is a frequent and serious complication in oncohaematological patients. It has a higher incidence and more reserved prognosis than that in the general population. This study's aim is to describe the epidemiological, clinical, etiological and evolutionary characteristics of ARF in patients with haematological malignancies. Methods: Retrospective study along 6 years (2009-2014) including oncohaematological patients with ARF admitted in the clinical hematology and intensive care departments. Results: Twenty eight patients were included among which 60.7% were women. The mean age was 41 years [4.5 years - 75 years]. The hospitalization was for chemotherapy cure (53.57%), sepsis or septic shock (21.42%), ARF (17.85%), lung metastasis (3.57%), and medullar compression syndrome (3.57%). The underlying disease was: acute lymphoblastic leukemia (14.28%), myeloma (35.71%), non hodgkinian lymphoma (32.14%), osteosarcoma (2 cases 7.14%), acute myelogenous leukemia (3.75%) and Hodgkin lymphoma (3.75 %). ARF was secondary for one or more of the following reasons: biological tumor lysis syndrome (28.57%), functional ARF (32.14%), sepsis (28.57%), tumor infiltration (17.85%), nephrotoxicity in cisplatin (10.71%) and fludarabine (3.57%) or obstructive ARF (3.57%). The use of hemodialysis was required in 71.4% of the cases. The indications were dominated by oligoanuria (60%) and hyperkalemia (50%). Only 10.7% of the patients recovered to normal renal function while 82% remained with renal failure and 0.7% developed toward end stage renal disease. The mortality rate was 39.28%. Most of deaths were secondary to septic shock. Conclusions: The ARF is common in patients with haematological malignancies. It complicates the management of patients and often strains prognosis . The etiologies leading to kidney failure in these patients are potentially multiple and often scheming. Patient's management is first through prevention as well as symptomatic management of renal failure. In addition, renal failure can lead the treatment to modification (reduced chemotherapy dose, contraindication for treatment) and these changes may compromise the patient treatment schedule.