Abstract: FR-PO529

Prevalence and Mortality of CKD in Lymphoma: A Large Retrospective Cohort Study

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Ubukata, Masamitsu, Tokyo Metropolitan Komagome Hospital,, Bunkyo-ku, Tokyo, Japan
  • Hara, Masaki, Tokyo Metropolitan Komagome Hospital,, Bunkyo-ku, Tokyo, Japan
  • Fujii, Teruhiro, Tokyo Metropolitan Komagome Hospital,, Bunkyo-ku, Tokyo, Japan
  • Ohta, Akihito, Tokyo Metropolitan Komagome Hospital,, Bunkyo-ku, Tokyo, Japan
Background

The prevalence, incidence, and mortality of chronic kidney disease (CKD) in lymphoma patients have not been fully understood. The objective of this study was to evaluate the prevalence of CKD and its contribution to mortality in patients with lymphoma.

Methods

This was a retrospective cohort study on 429 consecutive lymphoma patients who were admitted or regularly visited our hospital from January 2013 to October 2016. The prevalence of CKD at enrollment was evaluated according to the modified CKD classification by the KDIGO (eGFR and proteinuria category). Dipstick proteinuria was classified into three grades: A1, for − and +/−; A2 for 1+ or 2+; and A3 for ≥3+. eGFR (mL/min/1.73 m2) was classified into six stages: G1 for ≥90, G2 for 60–89, G3a for 45–59, G3b for 30–44, G4 for 15–29, and G5 for <15. CKD was defined as eGFR <60 mL/min/1.73 m2 and/ or proteinuria ≥1+ that was sustained at least for 3 months. The severity of CKD was classified into the following four categories: no risk for G1A1 and G2A1; moderate risk for G1A2, G2A2, and G3aA1; high risk for G1A3, G2A3, G3aA2, and G3bA1; and very high risk for G3aA3, G3bA2, G3bA3, G4, and G5.
The cumulative mortality rate was estimated using the Kaplan–Meier method, with stratification into two groups based on the presence or absence of CKD. Further, a multivariate Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and its 95% confidence interval (CI) for all-cause mortality, after adjustments for age, gender, pathologic type, clinical stage of lymphoma, presence or absence of diabetes mellitus, hypertension, and cardiovascular disease.

Results

The mean follow-up period was 3.1 ± 1.0 years and the prevalence of CKD at study enrollment was 34.5%. The cumulative mortality rate was 20.7% and was significantly higher in the CKD group than in the group without CKD (36.4% vs. 18.0%, p = 0.02). In the multivariate analysis, mortality was significantly associated with CKD (HR 1.61; 95% CI 1.03–2.50), and this association was the most robust with very high risk CKD (HR 6.32; 95% CI 2.41–14.54).

Conclusion

CKD should be considered a risk factor for mortality among patients with lymphoma.