Urothelial Carcinoma in Patients With Advanced Kidney Disease: A 12-Year Retrospective Cohort Survey

Abstract Introduction The goal of this study was to compare the clinical and pathological features of urothelial carcinoma (UC) identified in patients with end-stage renal disease (ESRD) and advanced-stage chronic kidney disease (CKD). The predictive value of CKD on patient mortality in these UC patients was also analyzed. Methods From January 1997 to December 2008, 141 patients with pathologically proven UC with stage 4/5 CKD (predialysis) and patients with ESRD receiving long-term dialysis were identified under an institutional review board approval protocol. The medical records and survival outcome of these patients were reviewed. Results A total of 141 UC patients with renal diseases (n = 97, 68.8%, of stage 4/5 CKD; n = 44, 31.2%, at dialysis) were enrolled. Patients with stage 4/5 CKD were significantly older, male gender, less anemic and more likely to have higher prevalence of diabetes mellitus ( P P P  = 0.039], male gender (HR = 6.822, P  = 0.016) and high-stage tumors (HR = 5.012, P  = 0.008) in patients with stage 4/5 CKD were independent predictors of mortality from UC. Conclusions Patients with stage 4/5 CKD had more aggressive histological UC patterns than did patients with ESRD.