A single center study of cancer patients with chronic kidney disease

Abstract

Purpose: It is clinically understood that chronic kidney disease (CKD) and cancer are interrelated. Yet, few studies measure how renal outcomes vary according to common malignancies and common therapeutic agents. We report the incidence and the nature of CKD among cancer patients from a single institution. Methods: A retrospective chart review of cancer patients managed in the onconephrology clinic at the Moffitt Cancer Center from 05/01/2015 to 07/31/2016 was conducted. Patients with kidney injury were included in this study. Renal function was recorded at three-month follow-up intervals for 15-month duration. Results: Out of the total 88 patients with median age of 68 years, 63 patients (~ 72%) were diagnosed with chronic kidney disease (CKD), whereas the remaining had acute kidney injury. Kidney cancer and multiple myeloma represented the single malignancies with the largest proportion of CKD with 12 patients each (~14% each). Patients with kidney cancer had a mean creatinine of (2.35, 1.74 SD) mg/dl compared to patients without kidney cancer with creatinine (1.97, 1.07 SD) mg/dl. Abdominal cancers represented the highest frequency category of malignancies in this sample (n = 38), and about 32 (84%) of these patients had CKD. About 80% of patients with genitourinary cancers (n = 27) had CKD. In terms of prescribed chemotherapeutic agents, patients treated with tyrosine kinase inhibitors had a lower average estimated glomerular filtration rate (28.37, 9.86 SD) mL/min/1.73 m 2 compared to other chemotherapeutic agents, though this was weakly significant (p-value = 0.07). Similar renal outcomes per malignancy and chemotherapy are reported. Conclusion: This group of patients demonstrated the frequency of chronic kidney disease differs depending on the type of malignancy or chemotherapy. A multidisciplinary approach involving oncologists and nephrologists should be adopted to prevent further renal damage from cancer and its therapies.