Patients who undergo surgical treatment of renal cell carcinoma (RCC) are at increased risk for end-stage kidney disease (ESKD), according to the findings of a population-based study presented at the 2022 European Association of Urology congress. Development of ESKD in these patients increases their risk for death.
Sven Lundstam, MD, PhD, of Sahlgrenska Academy of Gothenburg in Sweden, and colleagues identified 9414 patients with RCC using the National Swedish Kidney Cancer Registry and compared them with a control group of 94,159 patients without RCC matched by age, sex, and country of residence. The investigators found a 2.5% cumulative 10-year incidence of new-onset ESKD in the RCC group, which was 10 times higher than in the control group.
Compared with the control arm, the RCC group had a significant 18.3-fold increased risk for ESKD within the first year of RCC diagnosis and a 7.3-fold increased risk from year 1 to 10 after diagnosis, Dr Lundstam reported.
Dr Lundstam’s team defined ESKD as chronic kidney disease stage 5 or treatment with dialysis or renal transplantation.
Multivariable analysis revealed risk factors for kidney failure in the kidney cancer cohort. Within the first year after RCC diagnosis, nephron-sparing surgery (partial nephrectomy or partial ablation) was significantly associated with a 61% decreased risk for ESKD compared with radical nephrectomy, Dr Lundstam reported. Female sex was significantly associated with a 35% lower risk for ESKD compared with male sex. Diabetes and hypertension were each significantly associated with a nearly 1.9-fold increased risk for ESKD compared with the absence of these comorbidities. T2-T4 disease was significantly associated with a 1.4-fold increased risk for ESKD compared with T1 disease. The presence vs the absence of chronic kidney disease stages 1-4 was significantly associated with a 15.5-fold increased risk for ESKD.
Patients with both RCC and ESKD had significantly worse 5-year survival rates compared with patients who only had RCC (29% vs 64%). Among the patients with the kidney cancer, kidney failure was significantly associated with a 2.4-fold increased risk for death.
Lundstam S, Akerlund J, Holmberg E, Ljungberg B, Stendahl M, Grenabo Bergdahl A. New onset end stage renal disease after treatment of renal cell carcinoma. Presented at: EAU 2022, July 1-4, 2022, Amsterdam, The Netherlands. Abstract A0128.