Abstract: SA-PO205
Predictors of Mortality in Patients with CKD and Cancer
Session Information
- Onco-Nephrology: Clinical
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onco-Nephrology
- 1500 Onco-Nephrology
Authors
- Portela Neto, Antonio Abel, University State of São Paulo, São Paulo, Brazil
- Frediani, Marcella Martins, Sao Paulo State Cancer Institute - USP, 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 death in cancer patients with CKD.
Methods
Among 516 outpatients with cancer referred to nephrology evaluation (2009-13), 251 had CKD according KDIGO definitions and at least 3 months of follow up. Clinical and biochemical data were retrieved from patient medical records. The Cox regression was used to examine the predictors of mortality.
Results
After a mean follow-up of 4.2±2 years, the mortality rate observed was 57%. The patients features are shown in Table1. In the Cox regression analyses, ongoing chemotherapy [aHR=2.4; CI 1.3-4.5, p=0.004], Karnofsky index < 80 [aHR=2.1; CI 1.1-3.9, p=0.025], and eGFR < 30 ml/min/1.73m2 [aHR: 1.9; CI 1.0-3.6, p<0.03) were the independent predictors of mortality in our population. Of note, kidney dysfunction remained a independet risk factor for mortality even after adjustments for age and the presence of metastasis.
Conclusion
Patients with cancer and CKD have a poor prognosis. Ongoing chemotherapy, Karnofsky index, and an eGFR lower than 30 ml/min/1.73m2 were independent factors associated to mortality.
Table 1. Baseline Features
| Death (n=142) | Surviving (n=109) | |
| Age (yr) | 67±12 | 65±11 |
| Female (%) | 25 | 31 |
| Metastasis (%) | 37 | 16* |
| Ongoing Chemotherapy (%) | 50 | 23* |
| Karnofsky index < 80 (%) | 38 | 20* |
| eGFR < 30 (%) | 36 | 22* |
| Serum Albumin > 4 g/dL (%) | 64 | 75* |
| Solid tumors (%) | 86 | 82 |
Results are expressed as mean±SD and percentage. * < 0.05 vs Death group.
Survival by eGFR