{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:21:36Z","timestamp":1787314896547,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,1,28]],"date-time":"2024-01-28T00:00:00Z","timestamp":1706400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Acute kidney injury (AKI) is a common complication among cancer patients, often leading to longer hospital stays, discontinuation of cancer treatment, and a poor prognosis. This study aims to provide insight into the incidence of severe AKI in this population and identify the risk factors associated with renal replacement therapy (RRT) and in-hospital mortality. Methods: This retrospective cohort study included 3201 patients with cancer and severe AKI admitted to a Comprehensive Cancer Center between January 1995 and July 2023. Severe AKI was defined according to the KDIGO guidelines as grade \u2265 2 AKI with nephrological in-hospital follow-up. Data were analyzed in two timelines: Period A (1995\u20132010) and Period B (2011\u20132023). Results: A total of 3201 patients (1% of all hospitalized cases) were included, with a mean age of 62.5 \u00b1 17.2 years. Solid tumors represented 75% of all neoplasms, showing an increasing tendency, while hematological cancer decreased. Obstructive AKI declined, whereas the incidence of sepsis-associated, prerenal, and drug-induced AKI increased. Overall, 20% of patients required RRT, and 26.4% died during hospitalization. A predictive model for RRT (AUC 0.833 [95% CI 0.817\u20130.848]) identified sepsis and hematological cancer as risk factors and prerenal and obstructive AKI as protective factors. A similar model for overall in-hospital mortality (AUC 0.731 [95% CI 0.71\u20130.752]) revealed invasive mechanical ventilation (IMV), sepsis, and RRT as risk factors and obstructive AKI as a protective factor. The model for hemato-oncological patients\u2019 mortality (AUC 0.832 [95% CI 0.803\u20130.861]) included IMV, sepsis, hematopoietic stem cell transplantation, and drug-induced AKI. Mortality risk point score models were derived from these analyses. Conclusions: This study addresses the demographic and clinical features of cancer patients with severe AKI. The development of predictive models for RRT and in-hospital mortality, along with risk point scores, may play a role in the management of this population.<\/jats:p>","DOI":"10.3390\/cancers16030561","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T05:14:32Z","timestamp":1706591672000},"page":"561","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Severe Acute Kidney Injury in Hospitalized Cancer Patients: Epidemiology and Predictive Model of Renal Replacement Therapy and In-Hospital Mortality"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7630-9555","authenticated-orcid":false,"given":"Roberto","family":"Cal\u00e7as Marques","sequence":"first","affiliation":[{"name":"Nephrology Department, Centro Hospitalar Universit\u00e1rio do Algarve, 8000 Faro, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3061-3767","authenticated-orcid":false,"given":"Marina","family":"Reis","sequence":"additional","affiliation":[{"name":"Nephrology Department, Centro Hospitalar Universit\u00e1rio de Coimbra, 3004 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gon\u00e7alo","family":"Pimenta","sequence":"additional","affiliation":[{"name":"Nephrology Department, Centro Hospitalar de Lisboa Ocidental, 2790 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3316-221X","authenticated-orcid":false,"given":"In\u00eas","family":"Sala","sequence":"additional","affiliation":[{"name":"Nephrology Department, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio, 4050 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4002-0965","authenticated-orcid":false,"given":"Teresa","family":"Chuva","sequence":"additional","affiliation":[{"name":"Nephrology Department, Instituto Portugu\u00eas de Oncologia do Porto, 4200 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4240-8082","authenticated-orcid":false,"given":"In\u00eas","family":"Coelho","sequence":"additional","affiliation":[{"name":"Nephrology Department, Instituto Portugu\u00eas de Oncologia do Porto, 4200 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Nephrology Department, Instituto Portugu\u00eas de Oncologia do Porto, 4200 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Paiva","sequence":"additional","affiliation":[{"name":"Nephrology Department, Instituto Portugu\u00eas de Oncologia do Porto, 4200 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0408-7057","authenticated-orcid":false,"given":"Jos\u00e9 Maximino","family":"Costa","sequence":"additional","affiliation":[{"name":"Nephrology Department, Instituto Portugu\u00eas de Oncologia do Porto, 4200 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Meraz-Munoz, A., Langote, A., Jhaveri, K.D., Izzedine, H., and Gudsoorkar, P. 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