Acute kidney injury in patients with malignancy: clinical characteristics, etiology and outcomes across KDIGO stages

Vollständiger Abstract

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Background: Acute kidney injury (AKI) is a frequent and serious complication in patients with malignancy, contributing to increased morbidity, mortality and adverse renal outcomes. This study evaluated the clinical profile, primary etiologies, laboratory characteristics and outcomes of oncology patients with AKI according to kidney disease. Improving global outcomes (KDIGO) staging. Methods: This retrospective observational study included 100 adult oncology patients with KDIGO-defined AKI admitted between May 2021 and April 2026. Patients were classified as KDIGO stage 1 (n=30), stage 2 (n=35) or stage 3 (n=35). Demographic characteristics, comorbidities, primary etiologies, laboratory parameters and clinical outcomes were compared across AKI stages. Results: Increasing AKI severity was associated with older age and a higher prevalence of diabetes mellitus, hypertension and hematological malignancies. Sepsis was the most common primary etiology of AKI across all stages. Progressive worsening of hematological, inflammatory, metabolic and biochemical parameters was observed with increasing KDIGO stage (all p<0.001). Complete renal recovery at discharge declined significantly from 83.3% in stage 1 to 20.0% in stage 3, while in-hospital mortality increased from 10.0% to 51.4% (p=0.001). Among hospital survivors, complete recovery at 3 months decreased from 88.9% to 29.4%, whereas progression to chronic kidney disease increased from 7.4% to 52.9% across stages 1 to 3 (both p<0.001). Hospital readmission was more frequent in patients with severe AKI (p=0.048). Conclusions: Higher KDIGO stage is associated with greater clinical and biochemical derangement, reduced renal recovery, increased CKD progression and higher mortality in oncology patients with AKI. Early recognition and timely intervention may improve renal and patient outcomes in this high-risk population.