Survival of Hematologic Malignancy In Patients With Early-Stage Chronic Kidney Disease (SHIP-CKD)

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.

We conducted a retrospective cohort study using electronic medical records of 1238 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.

Among 1238 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).

Early-stage CKD was common among patients with hematologic malignancies and associated with higher unadjusted mortality, but not with increased mortality after adjusting for age, sex, and comorbidities. These findings suggest that early-stage CKD may not independently impact survival among patients with hematologic malignancies.