Chronic Kidney Disease in Cancer Patients: An Independent Predictor of Cancer-Specific Mortality

BACKGROUND/AIMS: The effects of chronic kidney disease (CKD) on the risk of death for patients with malignant disease are uncertain. The aim of this study was to determine the association between the presence of CKD and mortality in cancer patients. METHOD: We retrospectively reviewed the cases of 8,223 cancer patients with one or more serum creatinine measurements from January 1, 2000 to December 31, 2004. The key outcome was cancer-specific mortality within the follow-up period. The cumulative incidence rate for death from cancer was estimated using methods of competing risks survival analysis. Cox proportional-hazards regression with the use of Fine and Gray's proportional-hazards model were evaluated in multiple analyses. RESULTS: CKD was associated with an increased risk of death in cancer patients. The adjusted hazard ratios were 1.12 for patients with an estimated glomerular filtration rate (eGFR) of 30-59 ml/min/1.73 m(2) (95% confidence interval 1.01-1.26, p = 0.04) and 1.75 for patients with an eGFR <30 ml/min/1.73 m(2) (95% confidence interval 1.32-2.32, p < 0.001). CONCLUSIONS: CKD should be considered a risk factor for survival among patients with cancer.