Abstract: PD66-03
Sources of Funding: none

Introduction

Kidney cancer treatment resulting in significant parenchymal loss may lead to end stage renal disease (ESRD) requiring hemodialysis. ESRD is associated with significant medical comorbidity and a high risk of mortality. Emerging data suggests that surgically induced chronic kidney disease (CKD) may portend a better prognosis than medical CKD, but it is unknown whether mortality in patients with surgically induced ESRD differs compared to medical ESRD. We sought to compare demographics and overall survival between patients with ESRD as a result of kidney cancer (KC) and with ESRD from other causes.

Methods

Retrospective review of patients with ESRD as a result of KC in the United States Renal Data System was performed for years 1999-2013. Demographic information and survival was compared to those patients with alternative causes of ESRD. Cox regression was used to identify independent predictors of survival.

Results

During the time period 1,586,104 patients with ESRD were evaluated, 9,116 (0.6%) of which were as a result of kidney cancer (KC). KC patients were more likely to be male (74.0% vs 55.6%, p<0.001) and older (67.9 vs 62.3 years, p<0.001), but were less likely to have diabetes (16.6% vs 42.1%, p<0.001), congestive heart failure (18.1% vs 31.7%, p<0.001), or cardiovascular disease (5.1% vs 9.3%, p<0.001). KC patients were significantly less likely to receive a kidney transplant (6.0% vs 12.8%, p<0.001). 5-year unadjusted mortality rates were 22.0% for those with KC compared to 31.8% for those with other causes of ESRD. On multivariate analysis, ESRD secondary to KC remained a predictor of mortality; as did older age, female sex, congestive heart failure, and chronic obstructive pulmonary disease.

Conclusions

ESRD as a result of KC is associated with less comorbidity than other causes, yet survival remains worse. This may be a result of increased mortality from malignancy in this population.

Funding

none