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Abstract: FR-PO805

Incidence and Mortality of Cancers Among ESRD Patients Receiving Hemodialysis or Peritoneal Dialysis: A National Cohort Study in Korea

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Ko, Young kyung, Konkuk University Medical Center, SEOUL, Korea (the Republic of)
  • Shin, Sug kyun, Ilsan Hospital NHIS, Goyang-si, GYEONGGI-DO, Korea (the Republic of)
  • Jo, Young-Il, Konkuk University Medical Center, Seoul, Korea (the Republic of)
Background

Patients with end-stage renal disease (ESRD) have a higher-than-normal cancer risk. However, the incidence and mortality of cancers in ESRD patients receiving hemodialysis (HD) or peritoneal dialysis (PD) have been rarely studied for Korean populations.

Methods

We analysed data from the National Health Insurance Service (NHIS) of Korea to identify the incidence and mortality of cancers in ESRD patients receiving HD or PD. The study population was all ESRD patients starting maintenance dialysis between 2006 and 2014. They were followed from initiation of dialysis until death, discontinuation of dialysis, or the end of 2015. Cox proportional hazard regression models was used to identify the risk factors for cancer in ESRD patients.

Results

Of 17,140 ESRD patients, 4,258 (24.8%) had been newly diagnosed with cancer. The incidence of any cancer was higher for certain subgroups: older age, DM, hypertension, stroke, and coronary artery disease. In age-, gender-, and 1:2 propensity score-matched general population, 24.7% had been newly diagnosed with cancer. Rate of cancer in HD patients was 1.06 times higher than in the general population (95% CI 1.025-1.110, p=0.0014), while PD patients did not differ from general population (HR 0.897, 95% CI 0.765-1.051, p=0.1782). There were no significant differences in rates of cancer (HD vs. PD, 24.9% vs. 21.7%), the time from start dialysis to diagnosis of cancer (HD vs. PD, 4.49±3.00 vs. 3.68±2.92 years), and mean age at diagnosis of cancer (HD vs. PD, 64.44±12.14 vs. 60.23±13.20 years) between patients on HD and PD. Figure-1 showed the overall survival curves of cancers after newly diagnosed in ESRD patients and general populations.

Conclusion

These results suggested that the frequency of cancer is higher in ESRD patients on HD, not PD, than in the Korean general population.