Association Between Cancer and Incident Acute Kidney Injury Among Medicare Fee-for-Service Population

Area of Science:

• Nephrology
• Oncology
• Epidemiology

Background:

• Acute kidney injury (AKI) is a common and serious complication in cancer patients.
• Multiple factors contribute to the development of AKI in this population.
• Understanding cancer-specific AKI risks is crucial for patient management.

Purpose of the Study:

• To investigate the contemporary associations between different types of cancer and the incidence of AKI.
• To quantify the risk of AKI across various cancer diagnoses in Medicare beneficiaries.

Main Methods:

• Retrospective observational study utilizing Medicare fee-for-service beneficiaries aged 66 years and older.
• Comparison of incident AKI rates between individuals with new cancer diagnoses and matched controls.
• Cause-specific Cox and Fine-Gray competing risk models were employed for analysis, adjusting for relevant covariates.

Main Results:

• The study identified over 482,000 cancer cases and matched controls.
• Highest 5-year AKI risks were observed for cancers of the renal pelvis and ureter (32.8%), multiple myeloma (32.6%), and kidney cancer (28.9%).
• Multiple myeloma showed a significantly higher adjusted hazard ratio for AKI compared to controls, while high-mortality cancers had lower AKI risks.

Conclusions:

• The risk of developing AKI varies substantially depending on the type of cancer.
• Multiple myeloma presents the most significant elevated risk for AKI among cancer patients.
• These findings underscore the importance of cancer-specific risk stratification for AKI.