title: Is chronic kidney disease an adverse factor in lung cancer clinical outcome? A propensity score matching study.
abstract: Comorbidity has a great impact on lung cancer survival. Renal function status may affect treatment decisions and drug toxicity. The survival outcome in lung cancer patients with coexisting chronic kidney disease (CKD) has not been fully evaluated. We hypothesized that CKD is an independent risk factor for mortality in patients with lung cancer.
  
  
  
  A retrospective, propensity-matched study of 434 patients diagnosed between June 2004 and May 2012 was conducted. CKD was defined as estimated glomerular filtration rate <60 mL/minute. Lung cancer and coexisting CKD patients were matched 1:1 to patients with lung cancer without CKD.
  
  
  
  Age, gender, smoking status, histology, and lung cancer stage were not statistically significantly different between the CKD and non-CKD groups. Kaplan-Meier survival analysis demonstrated a median survival of 7.26 months (95% confidence interval [CI] 6.06-8.46) in the CKD group compared with 7.82 months (95% CI 6.33-9.30) in the non-CKD group (P = 0.41). Lung cancer stage-specific survival is not affected by CKD. Although lung cancer patients with CKD presented with an increased risk of death of 6%, this result was not statistically significant (hazard ratio 1.06, 95% CI 0.93-1.22; P = 0.41).
  
  
  
  According to our limited experience, CKD is not an independent risk factor for survival in lung cancer patients. Clinicians should not be discouraged to treat lung cancer patients with CKD.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital at ChiaYi and Chang Gung University, Putz City, Taiwan.
authors.forename: Ming-Shian
authors.identifier: 0000-0002-9619-0288
authors.initials: MS
authors.lastname: Lu
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital at ChiaYi, Putz City, Taiwan.
authors.forename: Miao-Fen
authors.initials: MF
authors.lastname: Chen
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital at ChiaYi, Putz City, Taiwan.
authors.forename: Chien-Chao
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital at ChiaYi, Putz City, Taiwan.
authors.forename: Yuan-Hsi
authors.initials: YH
authors.lastname: Tseng
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital at ChiaYi and Chang Gung University, Putz City, Taiwan.
authors.forename: Yao-Kuang
authors.initials: YK
authors.lastname: Huang
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital at ChiaYi, Putz City, Taiwan.
authors.forename: Hui-Ping
authors.initials: HP
authors.lastname: Liu
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chang Gung Memorial Hospital at ChiaYi, Putz City, Taiwan.|Department of Respiratory Therapy, Chang Gung University, Putz City, Taiwan.
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D009367:Neoplasm Staging; D057216:Propensity Score; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
keywords: 
  Chronic kidney disease; lung cancer; outcome; survival