PERSPECTIVE article
Front. Nephrol.
Sec. Critical Care Nephrology
Volume 5 - 2025 | doi: 10.3389/fneph.2025.1597253
This article is part of the Research TopicAKI in patients with neoplasiaView all articles
The impact of renal dysfunction after critical illness on the management of cancer
Provisionally accepted
- 1Faculdade de Medicina do ABC, Santo André, Brazil
- 2D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Rio de Janeiro, Brazil
- 3Rede D'Or São Luiz S.A., São Paulo, São Paulo, Brazil
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A 67-year-old male patient with limited-stage diffuse large B-cell lymphoma was on an R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy regimen. His Eastern Cooperative Oncology Group (ECOG) Performance Scale score was zero, indicating functional independence for activities of daily living.The patient was admitted to the intensive care unit (ICU) with septic shock in the presence of febrile neutropenia progressing to acute kidney injury, hypoxemic respiratory failure, and systemic arterial hypotension, in addition to the already established hematological dysfunction with thrombocytopenia.During his 32-day ICU stay, he required invasive mechanical ventilation, renal replacement therapy (RRT) and vasopressor drugs, with a focus on control of the infection.The patient was discharged from the ICU with sarcopenia and a serum creatinine level of 2.3 mg/dL, indicating a clearance rate of 24 ml/min/1.73 m 2 . Oxygen supplementation was needed.What impact did critical illness, more specifically renal dysfunction, have on the planning of onco-hematological treatment in this patient?
Keywords: AKI (acute kidney injury), Post intensive care syndrome (PICS), Cancer, Chemothearpy, intenisve care
Received: 20 Mar 2025; Accepted: 25 Apr 2025.
Copyright: © 2025 Romano, Chaves, Alves and Palomba. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Thiago Gomes Romano, Faculdade de Medicina do ABC, Santo André, Brazil
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