Prevalência das alterações renais nos pacientes com câncer hematológico em tratamento antineoplásico

Abstract

Cancer is a disease considered to be a serious public health problem and amongthe types of neoplasms, the hematologic most frequent ones include leukemias, Hodgkin's and non-Hodgkin's lymphomas, and multiple myeloma. The anti-neoplastic, especially chemotherapy, cause toxicity to the kidneys. The aim of this study is to analyze in patients with oncohematologic, malignancies, the prevalence of renal disturbance under antineoplastic treatment. This is a retrospective cohort study with a descriptive and analytical approach. Patients above 18 years old affected by hematological cancer who were or are still undergoing antineoplastic chemotherapy, between the period 2012 to 2018, compound the study population. All patient who have or have been undergoing treatment for hematologic cancer in the last six years and above 18 years were included. The sociodemographic data, clinical aspects, biochemical blood evaluation and glomerular filtration rate (GFR) were analyzed using the equation of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI).The data were tabulated and later transferred to the Statistical Package for Social Sciences software, version 20.0 for Windows. Either Fisher's exact test or Pearson's chi-square were used. Data from the tests were expressed as mean and standard deviation and analyzed by the Mann-Whitney test (non-parametric data). These variables were analyzed by multinomial logistic regression model at each level. Results with p <0.05 were considered significant. The prevalence of renal changes in the studied population was 52.4% considering the episodes of GFR by means of the CKD-EPI equation.The association between the reduction of the GFR and the female variables (p = 0.002), the diagnosis of multiple myeloma (p = 0.008), the start of treatment up to 40 days (P = 0.005), the Cyclophosphamide, Oncovin, prednisone protocol p = 0.026), treatments with idarubicin (p = 0.032), Vidaza, Dexamethasone, cyclophosphamide(p <0.001), zoledronate (p <0.001) and pamidronate (p = 0.012) showed significant association between.The Cancer and Leukemia Group B (CALGB) protocol (p <0.001) is inversely associated with reduced GFR.It is concluded that the prevalence of renal alterations in patients with hematological cancers submitted to chemotherapy treatment is high, requiring a periodic monitoring of renal function evaluation in this population.