Survival of hematologic malignancy in patients with early-stage chronic kidney disease (SHIP-CKD).

Abstract

7089 Background: Chronic kidney disease (CKD) is a common comorbidity among cancer patients and may influence treatment options and outcomes. However, the independent effect of CKD in patients with hematologic malignancies remains unclear. Methods: We conducted a retrospective cohort study using electronic medical records, including 1,238 adult patients diagnosed with hematologic malignancies between 2015 and 2019. Patients with CKD stages 1–3A were compared to those without CKD. The primary outcome was 5-year all-cause mortality. We used stratified Cox proportional hazards models adjusted for age, sex, and comorbidities (HIV, diabetes, hypertension, and COPD) and performed 1:1 propensity score matching without replacement. Subgroup analyses by cancer subtypes were performed. Results: Among 1,238 patients, 529 (42.7%) had CKD. CKD patients were older (67 vs. 55 years), with higher rates of hypertension (66.0% vs. 48.0%). Five-year mortality was higher in the CKD group (24.4% vs. 17.8%, p =0.006). In adjusted Cox models, CKD was not significantly associated with mortality (HR 1.08; 95% CI: 0.82–1.43). Subgroups by stages showed no significant risk: stage 1 (HR 1.27; 95% CI: 0.76–2.13), stage 2 (HR 1.05; 95% CI: 0.77–1.43), stage 3A (HR 1.03; 95% CI: 0.60–1.78). In matched analysis (n=758), CKD remained non-significant (HR 1.04; 95% CI: 0.77–1.41). Conclusions: Early-stage CKD was common and linked to higher unadjusted mortality, but not with increased mortality after adjusting for covariates. These findings suggest that early-stage CKD may not independently impact survival among patients with hematologic malignancies. Baseline characteristics by CKD status after propensity score matching. No CKD CKD P-value N=379 N=379 Age (years) 63.0 [57.0,68.0] 64.0 [56.0,69.0] 0.886 BMI (kg/m 2 ) 26.1 [23.5,29.9] 25.9 [23.3,29.8] 0.626 CKD  No CKD 379 (100.0%) 0 (0.0%) <0.00  G1 0 (0.0%) 58 (15.3%)  G2 0 (0.0%) 267 (70.4%)  G3a 0 (0.0%) 54 (14.2%) Sex  Female 154 (40.6%) 165 (43.5%) 0.46  Male 225 (59.4%) 214 (56.5%) Race/Ethnicity  White 207 (54.6%) 245 (64.6%)  Latino 67 (17.7%) 39 (10.3%)  Asian 52 (13.7%) 44 (11.6%)  Black or African American 21 (5.5%) 24 (6.3%)  Multi-Race/Ethnicity 11 (2.9%) 11 (2.9%)  Native American or Alaska Native 0 (0.0%) 2 (0.5%)  Native Hawaiian or Other Pacific Islander 2 (0.5%) 0 (0.0%)  Southwest Asian and North African 3 (0.8%) 3 (0.8%)  Other 11 (2.9%) 5 (1.3%)  Unknown/Declined 5 (1.3%) 6 (1.6%) Disease  Follicular lymphoma 3 (0.8%) 3 (0.8%) 1.00  Non-follicular lymphoma 67 (17.7%) 67 (17.7%)  Myeloma 200 (52.8%) 200 (52.8%)  Acute leukemia 56 (14.8%) 56 (14.8%)  Chronic leukemia 53 (14.0%) 53 (14.0%) HIV status  No HIV 372 (98.2%) 374 (98.7%) 0.77  HIV 7 (1.8%) 5 (1.3%) Diabetes status  No DM 316 (83.4%) 318 (83.9%) 0.92  DM 63 (16.6%) 61 (16.1%) Hypertension status  No HT 151 (39.8%) 154 (40.6%) 0.88  HT 228 (60.2%) 225 (59.4%) COPD status  No COPD 369 (97.4%) 372 (98.2%) 0.63  COPD 10 (2.6%) 7 (1.8%)