Incidence of renal injury following chemotherapy in malignant tumor patients and analysis of associated factors

Objective: To systematically investigate the clinical characteristics, peri-chemotherapy changes in renal function, and independent risk factors associated with chemotherapy-related renal injury (CRI) in patients with malignant tumors, providing scientific basis for developing individualized prevention and intervention strategies. Methods: = 124) based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. CRI was defined as a composite endpoint comprising either acute kidney injury (AKI) occurring within 1 week after the first chemotherapy cycle, or chronic kidney disease (CKD) persisting for more than 3 months post-chemotherapy. Renal function was assessed at standardized time points: within 1 week after cycle 1 and at the 3-month follow-up. The timing of post-chemotherapy renal function assessment was standardized for all patients, with the first evaluation conducted within 1 week following the completion of the first chemotherapy cycle (to capture AKI events) and a second evaluation performed at the 3-month follow-up visit (to assess CKD persistence). Patient demographics (age, gender, BMI, etc.), comorbidities (hypertension, diabetes, chronic kidney disease, etc.), tumor-related information (type, stage), chemotherapy regimens (use of nephrotoxic drugs, number of drugs), and renal function indicators before and after chemotherapy [serum creatinine (SCr), blood urea nitrogen (BUN), uric acid (UA), estimated glomerular filtration rate (eGFR)] were collected from the hospital electronic medical record system. Univariate analysis screened CRI-associated factors, followed by multivariate logistic regression to identify independent risk factors. Results: = 0.011) were factors independently associated with CRI occurrence. Conclusion: This study identifies a relatively high incidence of CRI among patients with malignant tumors undergoing chemotherapy. The findings suggest that age ≥ 60 years, diabetes, chronic kidney disease, use of nephrotoxic agents, and an increased number of chemotherapy drugs are associated with higher risk of CRI. However, due to the retrospective design and limited number of CRI events, these findings should be interpreted with caution. Further prospective studies with larger sample sizes are needed to validate these associations. These associations highlight the need for enhanced renal function monitoring and cautious selection of chemotherapy regimens, particularly in high-risk populations.