#5686 CANCER STATUS AND MORTALITY IN ELDERLY INCIDENT HEMODIALYSIS PATIENTS

Abstract

Abstract Background and Aims Chronic kidney disease and elderly people are associated with an increased risk of malignancy. But it remains unclear whether older patients with active cancer or a history of previous cancer and those without a cancer history carry the same mortality risk after initiation of hemodialysis (HD). Hence, we investigated the prognosis according to cancer status in elderly patients who started HD. Method Using a retrospective cohort of the Korean Society of Geriatric Nephrology, in this analysis, we included 2,085 patients older than 70 years who initiated hemodialysis between 2010 and 2017. Primary outcome of all-cause mortality was assessed using the Kaplan-Meier survival estimator and Cox proportional hazards regression analysis. Results At recruitment, 262 (12.6%) had a history of previous cancer and 55 (2.6%) had active cancer. During a median follow-up of 3.2 years, 1357 (65.1%) died. All-cause mortality was significantly higher in the active cancer group than in the previous cancer group and the no cancer group (85.5% vs 68.3% vs 64.0%, p < 0.002). Kaplan-Meier analysis revealed that all-cause mortality was significantly different among the 3 groups (p < 0.001, by log-rank test). After adjustment for various clinical factors, multivariate Cox regression analysis showed a strong association of active cancer with all-cause mortality (HR:1.89; 95%CI: 1.36–2.64; p < 0.001). However, previous cancer was not related to an increased risk of overall mortality (HR:1.07; 95%CI: 0.90–1.28; p = 0.448) Conclusion Active cancer was associated with high mortality in incident older hemodialysis patients. But patients with a history of previous cancer had a similar mortality risk compared to patients without a cancer history. Therefore, our study suggests that older cancer survivors may be able to maintain dialysis successfully.