End-stage renal disease after renal cell carcinoma linked to shorter survival
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Risk for new-onset end-stage renal disease is considerably higher after treatment for renal cell carcinoma, according to results of a nationwide population-based study.
Individuals with renal cell carcinoma who developed end-stage renal disease after treatment appeared significantly less likely to survive 5 years, findings presented at International Kidney Cancer Symposium: North America showed.
End-stage renal disease results in poorer quality of life and also is associated with considerable treatment costs, according to study background.
Sven Lundstam, MD, PhD, senior urologist at Sahlgrenska University Hospital in Sweden, and colleagues examined risk factors for end-stage renal disease after renal cell carcinoma treatment, as well as the impact of this condition on survival.
Researchers used the National Swedish Kidney Cancer Register from 2005 to 2014 to identify patients with renal cell carcinoma. They matched each patient with 10 controls.
Investigators defined end-stage renal disease as chronic kidney disease stage V, or those who underwent renal transplantation or dialysis after renal cell carcinoma diagnosis.
The analysis included 9,299 patients with renal cell carcinoma who did not have end-stage renal disease at the time of cancer diagnosis, as well as 93,895 controls.
Researchers determined 215 of those with renal cell carcinoma and 302 of those in the control group subsequently developed end-stage renal disease.
Results showed a 2.5% cumulative incidence of end-stage renal disease at 10 years among the renal cell carcinoma cohort, about 10 times that observed in the control group (P < .001). About half of end-stage renal disease diagnoses in the renal cell carcinoma cohort occurred within the first 2 years of cancer diagnosis.
Variables associated with increased risk for end-stage renal disease in the renal cell carcinoma cohort included sex (women vs. men, HR = 0.65; 95% CI, 0.47-0.9), T classification (T2-T4 vs. T1, HR = 1.4; 95% CI, 1.01-1.92), diabetes (yes vs. no, HR = 1.89; 95% CI, 1.31-2.73), hypertension (yes vs. no, 1.87; 95% CI, 1.36-2.56) and chronic kidney disease (yes vs. no, HR = 15.5; 95% CI, 8.57-27.9).
In the renal cell carcinoma cohort, researchers reported 5-year survival rates of 29% among those who developed end-stage renal disease and 64% for those without (HR for death = 2.4; 95% CI, 2-3).
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Lundstam L, et al. Abstract 14. Presented at: International Kidney Cancer Symposium: North America; Nov. 4-5, 2022; Austin, Texas.
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