Oliver Königsbrügge1, Felix Lötsch1, Christoph Zielinski2, Ingrid Pabinger1, Cihan Ay3. 1. Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria. 2. Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria. 3. Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria. Electronic address: cihan.ay@meduniwien.ac.at.
Abstract
INTRODUCTION: The risk for occurrence of venous thromboembolism (VTE) in cancer patients has been the aim of numerous investigations. Chronic kidney disease (CKD) is a frequent comorbidity in cancer patients and has been found to be a risk factor for VTE in the general population. We investigated the association of CKD with VTE and mortality in cancer patients. METHODS: Patients were recruited into the prospective cohort study, Vienna Cancer and Thrombosis Study (CATS). CKD was estimated with equations for glomerular filtration rate (eGFR) based on serum creatinine by Modification of Diet in Renal Disease (MDRD), CKD Epidemiology collaboration (CKD-EPI) and Cockcroft-Gault equation (C-G). Patients were subsequently classified to stages of CKD according to the Kidney Diseases Outcomes Quality Initiative. Primary endpoint was occurrence of VTE and secondary endpoint was death. RESULTS: The cohort of 1100 patients was prospectively followed over a median of 723 days. CKD with an eGFR of under 90 ml/min was common with a prevalence of 71.1%, 67.0% or 51.5% of patients calculated with MDRD, CKD-EPI and C-G equations, respectively, but severe CKD (eGFR<30 ml/min) was rare. Patients with a moderately decreased eGFR (90-60 ml/min/1.73 m(2)) based on CKD-EPI had a subdistribution hazard ratio of 0.68 (95% confidence interval 0.43-1.06). An association between CKD and occurrence of VTE or mortality could also not be shown with the other equations. CONCLUSIONS: In our investigation of a large cohort of cancer patients with a high prevalence of CKD, a reduced eGFR was not an independent risk factor for occurrence of VTE or death.
INTRODUCTION: The risk for occurrence of venous thromboembolism (VTE) in cancerpatients has been the aim of numerous investigations. Chronic kidney disease (CKD) is a frequent comorbidity in cancerpatients and has been found to be a risk factor for VTE in the general population. We investigated the association of CKD with VTE and mortality in cancerpatients. METHODS:Patients were recruited into the prospective cohort study, Vienna Cancer and Thrombosis Study (CATS). CKD was estimated with equations for glomerular filtration rate (eGFR) based on serum creatinine by Modification of Diet in Renal Disease (MDRD), CKD Epidemiology collaboration (CKD-EPI) and Cockcroft-Gault equation (C-G). Patients were subsequently classified to stages of CKD according to the Kidney Diseases Outcomes Quality Initiative. Primary endpoint was occurrence of VTE and secondary endpoint was death. RESULTS: The cohort of 1100 patients was prospectively followed over a median of 723 days. CKD with an eGFR of under 90 ml/min was common with a prevalence of 71.1%, 67.0% or 51.5% of patients calculated with MDRD, CKD-EPI and C-G equations, respectively, but severe CKD (eGFR<30 ml/min) was rare. Patients with a moderately decreased eGFR (90-60 ml/min/1.73 m(2)) based on CKD-EPI had a subdistribution hazard ratio of 0.68 (95% confidence interval 0.43-1.06). An association between CKD and occurrence of VTE or mortality could also not be shown with the other equations. CONCLUSIONS: In our investigation of a large cohort of cancerpatients with a high prevalence of CKD, a reduced eGFR was not an independent risk factor for occurrence of VTE or death.
Authors: Oliver Königsbrügge; Florian Posch; Julia Riedl; Eva-Maria Reitter; Christoph Zielinski; Ingrid Pabinger; Cihan Ay Journal: Oncologist Date: 2016-01-13
Authors: Julia Riedl; Florian Posch; Oliver Königsbrügge; Felix Lötsch; Eva-Maria Reitter; Ernst Eigenbauer; Christine Marosi; Ilse Schwarzinger; Christoph Zielinski; Ingrid Pabinger; Cihan Ay Journal: PLoS One Date: 2014-10-27 Impact factor: 3.240
Authors: Joanna Rupa-Matysek; Marta Lembicz; Eliza Katarzyna Rogowska; Lidia Gil; Mieczysław Komarnicki; Halina Batura-Gabryel Journal: Med Oncol Date: 2018-04-03 Impact factor: 3.064