Renal Replacement Therapy for Acute Kidney Injury in ICU
Conditions
Keywords
tumoral lysis syndrome, acute kidney injury, renal replacement therapy, timing
Brief summary
The TENDERS study aims to evaluate the impact of the timing of renal replacement therapy (RRT) initiation on outcomes in patients with tumor lysis syndrome (TLS) and associated acute kidney injury (AKI). The study will compare early versus delayed RRT initiation, examining the effect on renal function at 30 days post-treatment.
Detailed description
Tumor lysis syndrome (TLS) is a common and life-threatening complication in patients with hematologic malignancies, characterized by severe metabolic imbalances due to rapid tumor cell destruction. This syndrome frequently leads to acute kidney injury (AKI), requiring renal replacement therapy (RRT) in about 50% of cases. Despite its clinical significance, there is a lack of consensus on the optimal timing of RRT initiation in TLS-related AKI. Studies in other forms of AKI suggest no difference in outcomes between early and delayed RRT initiation, but these results are not directly applicable to TLS patients. This study seeks to fill this gap by analyzing the timing and outcomes of RRT initiation in TLS patients. The retrospective study will collect data from multiple intensive care units (ICUs) across France. Procedure: The study will retrospectively analyze patient data from 2013 to 2023, comparing early vs. delayed RRT initiation. Follow-up: Data on renal function, RRT usage, and mortality will be collected 30 days and one year after ICU admission.
Interventions
None listed
Sponsors
University Hospital, Bordeaux
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged ≥18 years. * Hospitalized in the ICU between January 1, 2013, and December 31, 2023. * Diagnosed with a hematologic malignancy or solid tumor requiring chemotherapy. * Diagnosed with TLS based on the presence of two or more biochemical criteria (e.g., hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia) within 3 days before or 7 days after chemotherapy initiation.
Exclusion criteria
* Patient or family opposition to data collection for research purposes. * Incomplete medical records that preclude data extraction.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Renal dysfunction at ICU discharge | From baseline to up to 30 days . | The primary outcome is renal dysfunction at ICU discharge, defined as a ≥25% increase in serum creatinine from baseline, assessed at the time of ICU discharge. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of AKI | At baseline | Incidence of AKI related to Tumor lysis syndrome (TLS), assessed at ICU admission. |
| Use of RRT for TLS-related AKI | From baseline to up to 30 days. | Use of RRT for TLS-related AKI, assessed during ICU stay. |
| Mortality at 12 months | 12 months after baseline | Mortality rate 12 months post ICU admission |
| Long-term renal function | 12 months after baseline | Long-term renal function is assessed by creatinine at one year |
| Mortality at 30 days | 30 days after baseline | Mortality rate at 30 days. |
| Renal recovery | At 90 days after baseline | 90-day renal recovery, assessed at 90 days post-admission. |
Countries
France
Contacts
Primary ContactArthur ORIEUX
Outcome results
None listed