Investigation On The Prevalence And Missed Diagnosis Of Chronic Kidney Disease In Hospitalized Patients With Malignant Tumor

Objective:To study the prevalence of chronic kidney disease(CKD)in patients with malignant tumors in the hospital and the missed diagnosis of CKD in patients with malignant tumors in various clinical departments,to deepen the understanding of malignant tumors with CKD,and to emphasize the renal function of patients with malignant tumors.Monitoring,reducing further damage to renal function during treatment,while providing some reference for clinical research work.Methods:Collected 1419 patients with malignant tumors from January 2018 to March 2018 in the hospital,and recorded their general clinical data(age,gender),past medical history,laboratory indicators(serum creatinine,this admission and previous urine protein),this admission and previous double renal imaging data(color ultrasound,CT,MR),diagnosis and treatment,clinical diagnosis,comorbidities,discharge department,estimated the eGFR by the creatinine formula of CKD-EPI.The renal function was grouped according to normal,AKI and CKD.To analyze the prevalence of CKD and the CKD missed diagnosis in patients with clinical malignant tumors.Logistic regression analysis risk factors for CKD in this population.(Note:Previous urine protein and previous imaging examinations refer to:at least 3 months from the time of admission)Results:(1)Among the 1419 patients with malignant tumors,the proportion of patients with normal renal function,AKI group and CKD group was 82.52%,0.78%,and 16.70%,respectively.(2)The male prevalence rate in the CKD group was 9.09%,and the female prevalence rate was 7.61%.There was no significant difference in the prevalence between male and female(X~2=0.000,p=1.000).113 patients with simple proteinuria in the CKD group,eGFR<60ml/(min 1.73m~2)in 89 cases,proteinuria and eGFR<60ml/(min 1.73m~2)in19 cases,imaging abnormalities in 15 cases,renal transplantation in 1 case,accounting for 47.68%,37.56%,8%,6.33%,0.42%.The proportion of each period of G1-G5 is33.3%,21.1%,36.7%,5.9%,2.95%;The proportion of 18-29,30-,40-,50-,60-,70-,80-,90-of all ages is 0.84%,3.38%,12.24%,18.14%,27.00%,19.41%,17.72%,1.27%.There were 174 patients had the complete information included the admission and discharged from the hospital of the CKD group,45 patients were discharged from the hospital with a worsening renal function among them,accounting for 25.86%.(3)Hypertension,diabetes,hyperuricemia were independent risk factors for CKD in hospitalized patients with malignant tumors(p<0.05).(4)Missed diagnosis of CKD in patients with malignant tumors in clinical departments:Among 237 patients with malignant tumors and CKD,174 cases were missed,and the total missed diagnosis rate was 73.42%.In the surgery,the breast cancer department,anorectal department,general surgery missed the higher rate,respectively,95.45%92.86%72.7%;internal medicine in the respiratory,gastroenterology,radiotherapy department missed the higher rate,respectively 93.3%84.6%82.35%.The lowest rate of missed diagnosis of ckd was nephrology in all departments,at 0%.Conclusion:The prevalence and missed diagnosis rate of CKD in patients with malignant tumors are high.Hypertension,diabetes,hyperuricemia are independent risk factors for CKD in patients with malignant tumors,which should be paid enough attention by clinicians to reduce the course of further damage to kidney function during the cancer treatment.