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Kidney Week

Abstract: FR-PO261

Cancer Status and Mortality in Older Hemodialysis Patients: Data from a Korean Society of Geriatric Nephrology Retrospective Cohort

Session Information

Category: Onconephrology

  • 1700 Onconephrology

Authors

  • Kang, Seongmin, University of Ulsan, Ulsan, Korea (the Republic of)
  • Hong, Yu Ah, Catholic University of Korea Daejeon St Mary's Hospital, Daejeon, Korea (the Republic of)
  • Park, Woo Yeong, Keimyung University Dongsan Medical Center, Daegu, Korea (the Republic of)
  • Cho, Jang-Hee, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Sun, In O, Presbyterian Medical Center, Jeonju, Jeollabuk-do , Korea (the Republic of)
  • Hwang, Won Min, Konyang University Hospital, Daejeon, Korea (the Republic of)
  • Kwon, Soon hyo, Soonchunhyang University Hospital, Yongsan-gu, Seoul, Korea (the Republic of)
  • Yoo, Kyung Don, University of Ulsan, Ulsan, Korea (the Republic of)
Background

Our study probed the correlation between cancer presence and mortality rates in elderly patients on hemodialysis, a link that is currently underexplored despite established associations between cancer, age, and chronic kidney disease (CKD).

Methods

We conducted a retrospective, multicenter cohort study through the Korean Society of Geriatric Nephrology. This study encompassed 2,085 patients aged 70 or above who commenced hemodialysis from 2010 to 2017. We employed the Kaplan-Meier survival estimator and Cox proportional hazards regression analysis to assess all-cause mortality.

Results

Among our cohort, 262 patients (12.6%) had a cancer history, while 55 patients (2.6%) were managing active cancer. Over a median follow-up period of 3.2 years, 1,357 deaths (65.1%) occurred. The active cancer group revealed significantly higher all-cause mortality in comparison to those with a cancer history or no cancer (85.5% vs 68.3% vs 64.0%; p<0.002). Kaplan-Meier analysis underscored this mortality disparity among the groups (p < 0.001, log-rank test). Further, the multivariate Cox regression analysis, post-adjustment for clinical variables, evidenced a strong correlation between active cancer and all-cause mortality (HR:1.89; 95%CI: 1.36–2.64; p < 0.001). However, a history of cancer did not significantly raise overall mortality (HR:1.07; 95%CI: 0.90–1.28; p = 0.448).

Conclusion

Elderly patients on hemodialysis with active cancer demonstrated a higher mortality rate compared to those with a history of cancer or no cancer. Interestingly, cancer survivors exhibited a mortality risk akin to those never diagnosed with cancer. Thus, elderly cancer survivors may be viable candidates for dialysis.

Pairwise log rank test showed all between-group comparisons significant.