Fig 1.
CONSORT diagram of survey-weighted estimates.
Of an estimated 515,145 hospitalizations for elective cancer resection identified in the 2016–2020 NIS, 32,195 (6%) presented with comorbid CKD (others: Non-CKD). Among patients with CKD, 81% had Stage 1–3 disease, 11% Stage 4–5 disease, and 8% End-Stage Renal Disease. All estimates represent survey-weighted methodology. *NIS, National Inpatient Sample; CKD, Chronic Kidney Disease; ESRD, End-Stage Renal Disease.
Fig 2.
Trends of comorbid chronic kidney disease among patients undergoing elective cancer resection.
The overall proportion of patients presenting with comorbid CKD increased over the study period, from 5.3% in 2016 to 7.3% in 2020 (P for trend<0.001, yellow line). Specifically, the proportion of patients undergoing cancer resection with concurrent CKD1-3 increased from 4.1 to 6.1% (P for trend<0.001), while the proportion with CKD4-5 increased from 0.6% to 0.7% (P for trend = 0.05). There was no significant change in the proportion of patients presenting with ESRD from 2016 to 2020 (0.5 to 0.5%, P for trend = 0.13). * indicates statistical significance, p<0.01.
Table 1.
Demographic, clinical, and hospital characteristics stratified by degree of CKD.
Fig 3.
Association of CKD with perioperative outcomes.
Following risk adjustment and with Non-CKD as reference, comorbid CKD was linked with greater likelihood of certain perioperative complications, need for blood transfusion, and non-home discharge, following elective cancer resection. * indicates statistical significance, P<0.05. Error bars represent 95% confidence intervals. *CKD, Chronic Kidney Disease.
Table 2.
Adjusted patient outcomes stratified by degree of CKD.
Fig 4.
Risk-adjusted mortality of CKD cohorts stratified by resection type.
A stepwise increase was noted in the adjusted risk of in-hospital mortality with greater degree of kidney disease. * indicates significance, P<0.001. *CKD, Chronic Kidney Disease; ESRD, End-Stage Renal Disease.
Fig 5.
Risk-adjusted costs of CKD cohorts stratified by resection type.
Increasing degree of renal dysfunction was associated with stepwise increases in hospitalization expenditures following colectomy, lobectomy, and pancreatectomy. Comorbid ESRD remained linked with greater costs across operations. * indicates statistical significance, P<0.001. *CKD, Chronic Kidney Disease; ESRD, End-Stage Renal Disease.