From the Guidelines
Yes, acute kidney injury (AKI) can be caused by non-small cell carcinoma (NSCLC). This can occur through several mechanisms, including direct tumor invasion into the kidneys, paraneoplastic syndromes, and tumor-related complications like hypercalcemia or tumor lysis syndrome, as discussed in the context of renal failure and AKI diagnosis 1. The treatments for NSCLC, including certain chemotherapy agents, targeted therapies, and immunotherapies, can be nephrotoxic and cause kidney injury, as outlined in the table of common anticancer drugs associated with AKI 1. Patients with NSCLC may also develop obstructive uropathy if the tumor or metastases block the urinary tract. Indirect effects such as dehydration, sepsis, or contrast agents used in diagnostic imaging can further increase the risk of AKI in cancer patients.
Some key points to consider in the management of AKI in NSCLC patients include:
- Regular monitoring of kidney function, especially in those undergoing treatment, to detect and manage AKI early 1.
- Understanding the mechanisms of AKI, including prerenal, renal, and postrenal causes, to guide appropriate intervention 1.
- Being aware of the nephrotoxic effects of various anticancer medications, such as cisplatin, carboplatin, and targeted therapies, to minimize AKI risk 1.
- Considering the individualized approach to treatment decisions in patients with AKI risk, including temporary discontinuation of certain medications like ACE inhibitors and ARBs during cancer treatment 1.
Overall, the management of AKI in NSCLC patients requires a comprehensive approach, taking into account the various mechanisms of kidney injury, the nephrotoxic effects of treatments, and the individual patient's risk factors and clinical context.
From the Research
Causes of Acute Kidney Injury
- Acute kidney injury (AKI) can be caused by various factors, including pre-renal, intrinsic renal, and post-renal lesions 2
- Cancer-related causes of AKI include urinary compression/obstruction, direct tumoral kidney involvement, and cancer-induced hypercalcaemia 3
- Non-small cell lung carcinoma can cause AKI due to direct metastatic invasion of the kidney, although this is a rare occurrence 4
Non-Small Cell Carcinoma and Acute Kidney Injury
- A case study reported a patient with non-small cell lung carcinoma who developed AKI due to extensive bilateral renal metastases, resulting in end-stage renal disease 4
- This case highlights the potential for non-small cell carcinoma to cause AKI, although it is not a common occurrence 4
Management of Acute Kidney Injury
- Management of AKI involves determining volume status, fluid resuscitation, treatment of volume overload, discontinuation of nephrotoxic medications, and adjustment of prescribed drugs according to renal function 5
- A multidisciplinary approach is necessary to reduce the incidence of AKI in cancer patients and improve patient outcomes 3