Impact of Chronic Kidney Disease on Outcomes of Surgical Resection for Primary Colorectal Cancer

Nozawa, Hiroaki; Kitayama, Joji; Sunami, Eiji; Watanabe, Toshiaki

doi:10.1097/dcr.0b013e3182600db7

Cited by 21 publications

(27 citation statements)

References 35 publications

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“… 16 Meanwhile, a retrospective cohort study of patients with colorectal cancer after surgical resection suggested that those with eGFR <15 mL/min/1.73 m 2 had a poorer overall survival. 15 Similar result was also observed in patients with gastric cancer after gastrectomy. 14 In agreement with previous studies, our data revealed that eGFR < 60 mL/min/1.73 m 2 was associated with higher risk for all-cause mortality among patients with hematologic malignancy and gynecological cancer than that of eGFR > 60 mL/min/1.73 m 2 , whereas no obvious relationship between renal function and death was observed for other cancers.…”

Section: Discussionsupporting

confidence: 73%

“…Moreover, cancer per se may have a strong influence on mortality rather than a reduced kidney function. 15 , 33 – 35 Therefore, the mechanisms underlying the impact of renal function on mortality among patients with different primary cancer are complex and remain to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

“… 10 , 13 – 18 Nevertheless, the results are inconsistent. Some studies provided supportive information of inverse association with different cutoff value of the eGFR, 10 , 13 – 15 whereas others suggested there was no relationship. 16 , 17 Notably, cancer per se may have a strong influence on mortality rather than a reduced kidney function, previous studies suggested that the association of eGFR and mortality varied by type of cancer.…”

Section: Introductionmentioning

confidence: 99%

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Renal Function and All-Cause Mortality Risk Among Cancer Patients

Yang

Zhou

et al. 2016

Medicine

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Renal dysfunction predicts all-cause mortality in general population. However, the prevalence of renal insufficiency and its relationship with mortality in cancer patients are unclear.We retrospectively studied 9465 patients with newly diagnosed cancer from January 2010 to December 2010. Renal insufficiency was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 using the Chronic Kidney Disease Epidemiology Collaboration equation. The hazard ratio (HR) of all-cause mortality associated with baseline eGFR was assessed by Cox regression.Three thousand sixty-nine patients (32.4%) exhibited eGFR <90 mL/min/1.73 m2 and 3% had abnormal serum creatinine levels at the time of diagnosis. Over a median follow-up of 40.5 months, 2705 patients (28.6%) died. Compared with the reference group (eGFR ≥ 60 mL/min/1.73 m2), an elevated all-cause mortality was observed among patients with eGFR < 60 mL/min/1.73 m2 stratified by cancer stage in the entire cohort, the corresponding hazard ratios were 1.87 (95% CI, 1.41–2.47) and 1.28 (95% CI, 1.01–1.62) for stage I to III and stage IV, respectively. However, this relationship was not observed after multivariate adjustment. Subgroup analysis found that eGFR < 60 mL/min/1.73 m2 independently predicted death among patients with hematologic (adjusted HR 2.93, 95% CI [1.36–6.31]) and gynecological cancer (adjusted HR 2.82, 95% CI [1.19–6.70]), but not in those with other cancer. Five hundred fifty-seven patients (6%) had proteinuria. When controlled for potential confounding factors, proteinuria was a risk factor for all-cause mortality among patients in the entire cohort, regardless of cancer stage and eGFR values. When patients were categorized by specific cancer type, the risk of all-cause death was only significant in patients with digestive system cancer (adjusted HR, 1.85 [1.48–2.32]).The prevalence of renal dysfunction was common in patients with newly diagnosed cancer. Patients with eGFR < 60 mL/min/1.73 m2 or proteinuria were associated with increased risk for all-cause mortality, this relation depended on cancer site.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Renal Function and All-Cause Mortality Risk Among Cancer Patients

Yang

Zhou

et al. 2016

Medicine

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“…Previous studies reported that renal insufficiency is an independent predictor of postoperative mortality and morbidity for a number of surgical procedures [5][6][7][8][9][10][11][12]. However, among nonsurgical patients, high estimated glomerular filtration rate (eGFR) levels have also been associated with greater mortality, resulting in a U-shaped association of eGFR with mortality [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

High and low estimated glomerular filtration rates are associated with adverse outcomes in patients undergoing surgery for gastrointestinal malignancies

Obi

Shimomura

et al. 2018

Nephrology Dialysis Transplantation

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“…However, their case series was not restricted to cancer operations and had a high proportion of stoma reversals, which present a different perioperative risk profile compared with resectional procedures. Nozawa et al [15]. compared the outcome of elective CRC resection in their institution between CKD and non-CKD groups and found an increased risk of postoperative cardiovascular morbidity in Stage 3-4 CKD, but no effect on overall postoperative mortality.…”

Section: Discussionmentioning

confidence: 98%

Impact of chronic kidney disease on postoperative outcome following colorectal cancer surgery

et al. 2014

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Impact of Chronic Kidney Disease on Outcomes of Surgical Resection for Primary Colorectal Cancer

Abstract: From these data, we conclude that surgical resection for colorectal cancer in patients with chronic kidney disease can be performed with acceptable outcomes.

Cited by 21 publications

References 35 publications

Renal Function and All-Cause Mortality Risk Among Cancer Patients

Renal Function and All-Cause Mortality Risk Among Cancer Patients

High and low estimated glomerular filtration rates are associated with adverse outcomes in patients undergoing surgery for gastrointestinal malignancies

Impact of chronic kidney disease on postoperative outcome following colorectal cancer surgery

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