Chronic kidney disease in cancer patients: an independent predictor of cancer-specific mortality.
OBJECTIVE
The effects of chronic kidney disease (CKD) on the risk of death for patients with malignant disease are uncertain. The aim of this study was to determine the association between the presence of CKD and mortality in cancer patients.


METHODS
We retrospectively reviewed the cases of 8,223 cancer patients with one or more serum creatinine measurements from January 1, 2000 to December 31, 2004. The key outcome was cancer-specific mortality within the follow-up period. The cumulative incidence rate for death from cancer was estimated using methods of competing risks survival analysis. Cox proportional-hazards regression with the use of Fine and Gray's proportional-hazards model were evaluated in multiple analyses.


RESULTS
CKD was associated with an increased risk of death in cancer patients. The adjusted hazard ratios were 1.12 for patients with an estimated glomerular filtration rate (eGFR) of 30-59 ml/min/1.73 m(2) (95% confidence interval 1.01-1.26, p = 0.04) and 1.75 for patients with an eGFR <30 ml/min/1.73 m(2) (95% confidence interval 1.32-2.32, p < 0.001).


CONCLUSIONS
CKD should be considered a risk factor for survival among patients with cancer.
Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
Sun Young
SY
Na
Ji Yoon
JY
Sung
Jae Hyun
JH
Chang
Sejoong
S
Kim
Hyun Hee
HH
Lee
Yeon Ho
YH
Park
Wookyung
W
Chung
Kook-Hwan
KH
Oh
Ji Yong
JY
Jung
D000328:Adult; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000502:physiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000401:mortality*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome