Abstract: SA-PO751
The Kidney Failure Risk Equation Predicts Progression to Hemodialysis in Cancer Patients with CKD
Session Information
- CKD: Epidemiology, Risk Factors, Prevention - III
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Souza, Luiz F., University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- L Leite, Ivens S., University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- Caires, Renato Antunes, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
- Coelho, Fernanda O., Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
- Mattedi, Francisco Zanotelli, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
- Torres, Veronica, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
- Costalonga, Elerson, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
Background
Cancer patients have a high prevalence of chronic kidney disease (CKD). The aim of this study was to assess prognostic factors for progression to hemodialysis (HD) in a cohort of cancer patients with CKD.
Methods
Among 397 outpatients with cancer referred to nephrology evaluation (2009-12), 202 had CKD according KDIGO definitions and at least 3 months of follow up. Clinical and biochemical data were retrieved from patient medical records. The primary endpoint was defined as progression to HD during follow up. The Cox regression was used to examine the association between the baseline features and progression to HD.
Results
Throughout a mean follow up period of 3.7±2.3 years, 10% of patients progressed to HD. Patients baseline features data are shown in Table 1. In the Cox regression analyses, the risk of HD estimated by the 4-variable Kidney Failure Risk Equation (aHR=1.05; 95% CI 1.03-1.06, p<0.001) was the strongest predictor of HD in our population after adjusments for CKD etiology.
Conclusion
In this cohort, traditional risk factors as hypertension, diabetes and albuminuria were associated with a greather risk of hemodialysis in univariated analysis. Beyond, the Kidney Failure Risk Equation was a good instrument for identifying a high risk of progression to HD among cancer patients with CKD.
Table 1. Baseline Features
| Hemodialysis (n=19) | No Hemodialysis (n=183) | |
| Age (yr) | 65±9 | 66±12* |
| Male (%) | 63 | 72 |
| Solid Tumors (%) | 89 | 85 |
| Metastasis (%) | 32 | 26 |
| Hypertension (%) | 95 | 74* |
| Baseline eGFR (ml/min/1.73m2) | 23±14 | 40±14 |
| Albuminuria > 300 mg/g | 80 | 23* |
| 5yr Kidney Failure Risk (%) | 51±37 | 7±12* |
| Diabetic Nephropathy (%) | 37 | 14* |
| Obstructive Nephropathy (%) | 21 | 16 |
| Follow up (yr) | 4.6±2 | 3.8±2 |
Results are expressed as mean±SD and percentage. * < 0.05 vs Hemodialysis group