癌症患者的慢性肾脏病：癌症特异性死亡率的独立预测因子。
Chronic kidney disease in cancer patients: an independent predictor of cancer-specific mortality.
机构信息
Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
出版信息
Am J Nephrol. 2011;33(2):121-30. doi: 10.1159/000323740. Epub 2011 Jan 14.
BACKGROUND/AIMS: The effects of chronic kidney disease (CKD) on the risk of death for patients with malignant disease are uncertain. The aim of this study was to determine the association between the presence of CKD and mortality in cancer patients.
METHOD
We retrospectively reviewed the cases of 8,223 cancer patients with one or more serum creatinine measurements from January 1, 2000 to December 31, 2004. The key outcome was cancer-specific mortality within the follow-up period. The cumulative incidence rate for death from cancer was estimated using methods of competing risks survival analysis. Cox proportional-hazards regression with the use of Fine and Gray's proportional-hazards model were evaluated in multiple analyses.
RESULTS
CKD was associated with an increased risk of death in cancer patients. The adjusted hazard ratios were 1.12 for patients with an estimated glomerular filtration rate (eGFR) of 30-59 ml/min/1.73 m(2) (95% confidence interval 1.01-1.26, p = 0.04) and 1.75 for patients with an eGFR <30 ml/min/1.73 m(2) (95% confidence interval 1.32-2.32, p < 0.001).
CONCLUSIONS
CKD should be considered a risk factor for survival among patients with cancer.
背景/目的：慢性肾脏病（CKD）对恶性肿瘤患者死亡风险的影响尚不确定。本研究旨在确定 CKD 与癌症患者死亡率之间的关系。
方法
我们回顾性分析了 2000 年 1 月 1 日至 2004 年 12 月 31 日期间 8223 例有一次或多次血清肌酐测量值的癌症患者的病例。主要结局是随访期间癌症特异性死亡率。使用竞争风险生存分析方法估计癌症死亡的累积发生率。使用 Fine 和 Gray 的比例风险模型对 Cox 比例风险回归进行了多次分析。
结果
CKD 与癌症患者的死亡风险增加相关。调整后的危险比为肾小球滤过率（eGFR）为 30-59 ml/min/1.73 m²的患者为 1.12（95%置信区间为 1.01-1.26，p = 0.04），eGFR <30 ml/min/1.73 m²的患者为 1.75（95%置信区间为 1.32-2.32，p < 0.001）。
结论
CKD 应被视为癌症患者生存的一个危险因素。
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