ORIGINAL RESEARCH article
Front. Oncol.
Sec. Pediatric Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1576639
This article is part of the Research TopicCritical Complications In Pediatric Oncology and Hematopoietic Cell Transplant - Volume IIIView all 7 articles
Hypoalbuminemia is associated with adverse outcomes in critically ill children with cancer
Provisionally accepted
- 1Le Bonheur Children's Hospital, Memphis, Tennessee, United States
- 2St. Jude Children's Research Hospital, Memphis, United States
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Introduction: Acute kidney injury (AKI) is a serious complication encountered often in critically ill children with cancer. Hypoalbuminemia, commonly present in this population, has been associated with poor outcomes, including a higher rate of AKI. Studies examining the impact of hypoalbuminemia on outcomes in critically ill children with cancer are lacking.Therefore, the objective of this study was to investigate the impact of low serum albumin levels (SAL) on outcomes, including mortality and AKI, in critically ill children with oncologic/hematologic diseases. We also sought to examine the risk factors of AKI in this population.Retrospective review of all children with hematologic/oncologic disease admitted to the intensive care unit (ICU) from December 2020 to April 2021.Results: A total of 82 patients were included in this study cohort. The median age in our cohort was 10.3 y (0.8, 22.3), and the most common diagnosis was hematologic malignancy (41%).Thirty percent of the cohort experienced AKI; 30% of these cases were severe. Risk factors for AKI included sepsis, antiviral medications, higher nephrotoxicity index, and a higher number of nephrotoxic drugs. The rate of AKI was higher in children with SAL <2.5 g/dL (55% vs 27% in children with SAL ≥2.5 g/dL, P=0.09). SAL <3 g/dL was associated with higher rate of invasive mechanical ventilation (IMV) (15% vs 2% in children with SAL≥3 g/dL, P=0.038) and a longer duration of ICU stay (4 days vs 2, P=0.028).Hypoalbuminemia is associated with adverse outcomes in children with oncologic/hematologic disease. Particularly, SAL < 3 g/dL are associated with higher need for IMV and longer ICU duration. Future studies are required to investigate the impact of hypoalbuminemia in this population and whether correcting hypoalbuminemia improves outcomes.
Keywords: Intensive Care Unit, Acute Kidney Injury, Children with cancer, Hypoalbuminemia, Survival, mechanical ventilation
Received: 14 Feb 2025; Accepted: 28 May 2025.
Copyright: © 2025 James, Ashcraft, Cheng and ELBAHLAWAN. 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: LAMA ELBAHLAWAN, St. Jude Children's Research Hospital, Memphis, United States
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