Relationship Between Cancer and Mortality Outcomes in Chronic Kidney Disease
Posted: Wednesday, November 13, 2019
According to a study published in BMC Nephrology of patients with chronic kidney disease, cancer appears to be an added burden and an independent risk factor for all-cause mortality, but not for renal disease progression. Rajkumar Chinnadurai, MBBS, MD, MRCP, of the University of Manchester, United Kingdom, and colleagues proposed that patients who have a history of cancer should be evaluated on a case-by-case basis when determining renal replacement therapy options. That said, cancer should not inhibit patients from receiving renal replacement therapies.
The investigators performed a comparative analysis of patients with chronic kidney disease. The authors compared 339 patients with a history of previous and current cancer and 2,613 patients without cancer at recruitment.
Overall, 1,084 patients (36.7%) died over a median follow-up of 48 months. The annual rate of new cancer diagnoses in the patient cohort without cancer was 1.6%. Due to their anatomic roles and relationship to nephrology, it was unsurprising that the most common cancers in the patient pool were urogenital cancers, prostate and testicular cancers in men, and ovarian and uterine cancers in women. All-cause mortality was 49.6% in the group with cancer and 35% in the group without cancer (P < .001). The researchers found a strong association between all-cause mortality and cancer (P = .004).
Within both cohorts, 26% of patients reached end-stage renal disease. There was no significant difference in the annual rate of decline in estimated glomerular filtration rate between the groups with and without cancer (P = .93). Renal replacement therapy uptake was also similar between the groups (P = .49).
Disclosure: The study authors reported no conflicts of interest.