Patients on dialysis for kidney failure are at elevated risk for postoperative complications and death after cancer surgery, according to investigators. The difference in risk varies by cancer type.

The study included 10,458 patients who underwent cancer surgery in Japan: 2248 patients with kidney failure on dialysis and 8210 matched control patients without kidney failure. The groups were matched by patient characteristics, cancer type, surgical procedure, and hospital. Each dialysis patient was matched with up to 4 controls.

The dialysis group had 807, 579, 500, and 362 patients with colorectal, lung, gastric, and breast cancer, respectively. The control group had 2851, 2216, 1756, and 1387 patients with these cancers, respectively.

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The in-hospital postoperative complication rates were significantly higher for the dialysis group than for the control group after colorectal (20.3% vs 14.6%), lung (18.0% vs 12.9%), gastric (25.0% vs 13.2%), and breast cancer (7.5% vs 3.5%) surgery, Yoshihisa Miyamoto, MD, of The University of Tokyo in Japan, and colleagues reported in Clinical Kidney Journal. The dialysis group had a significantly higher 30-day mortality rate compared with the control group following gastric surgery (1.6% vs 0.3%). Heart failure and ischemic heart disease occurred more frequently in the dialysis group.

“Surgeons, anesthesiologists, and nephrologists should provide patients with [kidney failure on dialysis] with multidisciplinary perioperative care to reduce their excess risk of postoperative complications,” the authors concluded.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Miyamoto Y, Iwagami M, Aso S, et al. Postoperative outcomes of cancer surgery in patients with and without kidney failure with dialysis therapy: A matched-pair cohort study. Clin Kidney J. Published online January 13, 2022. doi:10.1093/ckj/sfac005