Abstract: FR-PO518

Cannabis Use and Its Association with Clinical Characteristics and Post-ESRD Mortality

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Potukuchi, Praveen Kumar, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Sumida, Keiichi, Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
  • Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Gaipov, Abduzhappar, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Park, Frank, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Moradi, Hamid, University of California Irvine, School of Medicine, Orange, California, United States
  • Thomas, Fridtjof, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Soohoo, Melissa, University of California Irvine, School of Medicine, Orange, California, United States
Background

The health effects of cannabis use in patients with advanced CKD are unknown.

Methods

In 11,154 US veterans who transitioned to dialysis during 2007-2014 and had undergone urine toxicology tests (1,381 who tested positive for cannabis, and 9,773 who tested negative for cannabis), we examined the association of cannabis use with various clinical characteristics using logistic regressions and with 6-month all-cause mortality using multivariable adjusted Cox models.

Results

The mean (SD) age of the cohort was 61.9 (9.7) years; 97% were male, 45 % were African American and 69% were diabetic. Cannabis use was associated with younger age, higher mean pre-ESRD eGFR, unmarried status, smoking, cancer, liver disease, HIV and with the prescription of opioids and antidepressants (Table). Patients who tested positive for cannabis displayed lower mortality than patients who tested negative [Figure, unadjusted hazard ratio (95% CI): 0.83(0.7-0.99)], but the survival advantage was attenuated after multivariable adjustments [1.06 (0.86-1.31), p=0.6].

Conclusion

Among patients who underwent toxicology testing, cannabis use during the pre-ESRD period is associated with lower all-cause mortality in the immediate post-ESRD period. However, this association mitigates when adjusted for patient characteristics.

 Cannabis use yes vs no OR, (95% CI)
Age at dialysis0.96 (0.95–0.97)
eGFR1.01 (1.01–1.01)
Single vs married1.29 (1.04–1.60)
Divorced vs married1.47 (1.25–1.72)
Smoking1.95 (1.62–2.35)
Cancer1.51 (1.11–2.06)
Liver disease2.03 (1.64–2.50)
HIV3.00 (1.46–6.18)
Opioid use1.45 (1.17–1.79)
Antidepressants use1.51 (1.27–1.80)

Funding

  • NIDDK Support