Résumé
Acute kidney injury (AKI) is associated with high morbidity and mortality and 75% of patients with hematological malignancies (HM) are at risk. We aimed to evaluate the impact on long-term prognosis of the occurrence of AKI in patients with HM who survived their critical care admission.This was a single-center retrospective cohort of patients with HM, admitted to the Intensive Care Unit between January 1, 2012 and December 31, 2020, separated into two groups according to the occurrence AKI. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criterias. The primary outcome was 3-year mortality.We described a cohort of 251 patients, 64.5% of which were males and the median age was 63 [52; 69]. The median Sequential Organ Failure Assessment was 5 [4; 8]. AKI occurred in 58.6% of the patients, including 36.7% KDIGO stage 1, 31.3% KDIGO stage 2 and 32% KDIGO stage 3. Of these, 25.6% required renal replacement therapy (RRT). Three-year mortality was 57.7% in patients without AKI and 66.7% in patients with AKI (p=0.27). There was a non-significant trend towards excessive 3-year mortality in patients who required RRT compared to those without AKI or KDIGO stage 1 (78.9% vs. 58.9%, p=0.07). Recovery of previous renal function was 86.8% without AKI and 69.9% with AKI (p<0.01).In patients developing AKI, 59.9% were able to continue their hematological course versus 73% without AKI (p=0.03). AKI affects more than half of the patients with HM admitted to the ICU, without significant impact on 3-year mortality.More than three quarters of the patients will recover a previous renal function and despite a more frequent modification of the hematological course in those with AKI, we do not note an impact on the progression of HM. AKI should not be a barrier to the admission of these patients to the ICU.