Kidney and cancer - causes of acute renal damage

Cancer is related to the causes of renal failure such as acute renal failure and chronic kidney failure both directly and indirectly. Kidney failure is often multifactorial in these patients.

  • Is acute kidney injury (AKI) common in neoplastic patients?
  • There is insufficient data on the exact percentage. Several studies show that AKI in ​​tumors is about 15% to 30% with more frequent occurrence in kidney neoplasm, multiple myeloma and liver cancer.
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  • What are the main causes of AKI in ​​a cancer patient?
  • -Causes associated with decreased kidney perfusion: such as AKI due to dehydration (vomiting, diarrhea), originating from very high blood calcium levels (which reduces kidney perfusion by various mechanisms), or medicines that reduce blood flow to the kidneys.
  • -Causes associated with "internal" kidney impairments: various types of glomerulonephritis related to the presence of cancer, assignment of substances produced by cancer in the kidney, vascular thrombosis associated with cancer.
  • -Causes related to the obstruction of urine flow from the kidney to the bladder: the coercion of cancer to the ureters, uric acid blocking the kidney tubules, large lymph nodes urging the urinary system.
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  • What is tumor lysis syndrome and is it associated with kidney damage?
  • It is a serious complication that occurs in patients mainly with tumors of hematological type after receiving treatment for the destruction of cancer cells. It generates much increased uric acid, along with its crystals that are created in the kidney tubules, causing kidney damage. It usually occurs 48 hours after the administration of the treatment. Besides uric acid, it also increases potassium. Oncologists along with nephrologists recognize people at risk for this syndrome, and nowadays these patients are preparing to reduce the appearance of this complication.
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  • Is there an association between cancer and glomerulonephritis?
  • Yes, glomerulonephritis can appear as a kidney “response” to the existence of cancer cells. The most common is membranous glomerulonephritis, which is often associated with the existence of some form of neoplasm in another organ. It is not completely acknowledged how this mechanism works, but rather antigens from the cancer cells "confuse" the body's defense system and make it harm the glomeruli.
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  • Can neoplasia "invade" the kidney by creating kidney failure?
  • Yes, it can invade. It is relatively common in lymphomas and leukemias. This "invasion" or more correctly, this infiltration can be expressed as acute kidney injury, such as albuminuria or hematuria. Renal ultrasound imaging can sometimes show kidneys size that has grown. With appropriate treatment and "removal" of cancer cells from the kidney, renal failure is often improved.
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  • How can calcium cause AKI? Can the calcium supplement that I take cause AKI?
  • No, the calcium supplement does not cause AKI when taken according to your doctor's instructions. More specifically, we refer to the calcium levels in the blood that increase greatly in some neoplasms (e.g. breast cancer, prostate or multiple myeloma). Serious hypercalcemia can cause acute kidney damage with two mechanisms - with too much diuresis that is caused (in this case our body is dehydrated) but also with the constriction (stenosis) of blood vessels that increase blood flow to the kidneys. Reduced blood flow leads to AKI, but it is a complication, widely known to oncologists and nephrologists, and is treated extremely well.
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  • In conclusion, AKI in ​​patients with neoplasia is relatively common. However, the degree of alertness of oncologists and nephrologists is particularly high in these issues, with most of these complications being treated immediately before they even manifest themselves clinically.
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  • Mesogeios Dialysis Centers Group Scientific Team 
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  • Bibliography
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