Association of chronic kidney disease with mortality risk in patients with lung cancer: a nationwide Taiwan population-based cohort study

Abstract

ObjectiveOur population-based research aimed to clarify the association between chronic kidney disease (CKD) and mortality risk in patients with lung cancer.DesignRetrospective cohort studySettingNational health insurance research database in TaiwanParticipantsAll (n=1 37 077) Taiwanese residents who were diagnosed with lung cancer between 1997 and 2012 were identified. Eligible patients with baseline CKD (n=2269) were matched with controls (1:4, n=9076) without renal disease according to age, sex and the index day of lung cancer diagnosis.MethodsThe cumulative incidence of death was calculated by the Kaplan-Meier method, and the risk determinants were explored by the Cox proportional hazards model.ResultsMortality occurred in 1866 (82.24%) and 7135 (78.61%) patients with and without CKD, respectively (P=0.0001). The cumulative incidences of mortality in patients with and without chronic renal disease were 72.8% vs 61.6% at 1 year, 82.0% vs 76.6% at 2 years and 88.9% vs 87.2% at 5 years, respectively. After adjusting for multiple confounding factors including age and comorbidities, Cox regression analysis revealed that CKD was associated with an increased risk of mortality (adjusted HR 1.38; 95% CI 1.29 to 1.47). Stratified analysis further showed that the association was consistent across patient subgroups.ConclusionComorbidity associated with CKD is a risk factor for mortality in patients with lung cancer.

Lung cancer outcome in the setting of chronic kidney disease: Does the glomerular filtration estimation formula matter?

“…In a recent population‐based cohort study in Taiwan of lung cancer patients with coexisting CKD, Wei et al . found that CKD increased the mortality risk by 38% . The authors used specific International Classification of Disease codes to determine CKD and included mostly CKD stage 5 patients .…”

“…8 In a recent population-based cohort study in Taiwan of lung cancer patients with coexisting CKD, Wei et al found that CKD increased the mortality risk by 38%. 7 The authors used specific International Classification of Disease codes to determine CKD and included mostly CKD stage 5 patients. 7 In this study, the CKD-CG showed a 4% decrease in survival in lung cancer patients with CKD (HR 0.96, 95% 0.88-1.08; P = 0.65) while the CKD-EPI showed a 5% increased risk of death (HR 1.05, 95% CI 0.95-1.17; P = 0.33) ( Table 5).…”

“…Chronic kidney disease (CKD) markers account for 4.4% of overall cancer incidence and are responsible for 3.3 years of life lost . However, studies of survival outcomes of lung cancer patients with deteriorated renal function have shown conflicting results in the literature . In this study, we first evaluated survival outcomes of patients with lung cancer and coexisting CKD using a propensity‐matched study using two commonly used formulas for estimating glomerular filtration rate.…”

“…3 However, studies of survival outcomes of lung cancer patients with deteriorated renal function have shown conflicting results in the literature. [4][5][6][7][8] In this study, we first evaluated survival outcomes of patients with lung cancer and coexisting CKD using a propensitymatched study using two commonly used formulas for estimating glomerular filtration rate. Second, we tested the hypothesis that CKD is an independent risk factor for mortality in patients with lung cancer.…”

Prediction of recurrence-associated death from localized prostate cancer with a charlson comorbidity index–reinforced machine learning model

“…Using the NHIRD, Wang’s work surveyed second primary malignancy risk after radiotherapy for patients with rectal cancer [13]. Researchers used the NHIRD to prove that the survival of lung cancer is affected by a common comorbidity, chronic renal insufficiency [14]. A type of Chinese herb was demonstrated to improve the survival of lung cancer with this database [15].…”