Abstract: SA-PO780
Worsening of Renal Function Predicts Mortality in Patients with Cancer and CKD
Session Information
- CKD: Epidemiology, Risk Factors, Prevention - III
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- L Leite, Ivens S., University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- Souza, Luiz F., University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- Caires, Renato Antunes, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
- Mattedi, Francisco Zanotelli, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
- Coelho, Fernanda O., Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
- Torres, Veronica, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
- Costalonga, Elerson, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
Background
Cancer patients have a high prevalence of chronic kidney disease (CKD). The aim of this study was to assess prognostic factors for death in cancer patients with CKD.
Methods
Among 397 outpatients with cancer referred to nephrology evaluation (2009-12), 202 had CKD according KDIGO definitions and at least 3 months of follow up. Clinical and biochemical data were retrieved from patient medical records. The Cox regression was used to examine the predictors of mortality.
Results
After a follow-up of 3.9±2 years, the mortality rate observed was 57%. The patients features are shown in Table1. In the Cox regression analyses, serum albumin (aHR=0.38; CI 0.28-0.54, p<0.001), ongoing chemotherapy [aHR=0.61; CI 0.38-0.97, p=0.038], and CKD progression [aHR: 2.54; CI 2.54-4.18, p<0.001), defined as a sustained decline in eGFR of more than 5ml/min/1.73m2/yr, were the independent predictors of mortality in our population. Of note, worsening of renal function remained a independet risk factor for mortality even after adjustments for important cancer related factors (presence of metastasis) and Karnofsky index.
Conclusion
Patients with cancer and CKD have a poor prognosis. Serum albumin, ongoing chemotherapy, and CKD progression were independent factors associated to mortality.
Table 1. Baseline Features
| Death (n=116) | Surviving (n=86) | |
| Age (yr) | 67±12 | 65±12 |
| Male (%) | 76 | 64 |
| Solid Tumors (%) | 86 | 84 |
| Metastasis (%) | 34 | 18* |
| Ongoing Chemotherapy (%) | 46 | 21* |
| Karnofsky index | 84±14 | 92±12* |
| Obstructive uropathy (%) | 21 | 10 |
| Baseline eGFR (ml/min/1.73m2) | 37±16 | 40±14 |
| Albuminuria > 300 mg/g (%) | 62 | 59 |
| Serum Albumin (g/dL) | 3.9±0.7 | 4.3±0.5* |
| Hemoglobin (g/dL) | 11.1±2 | 12.1±2* |
| CKD progression (%) | 32 | 9* |
Results are expressed as mean±SD and percentage. * < 0.05 vs Death group.