Neoplasia in Hemodialysis Patients and Its Effect on Anemia Treatment, Vascular Access and Kidney Transplant Eligibility

Abstract

Chronic kidney disease and neoplasia are a growing problem worldwide. The aim of our study was to assess anemia treatment, type of vascular access (VA) and access to kidney transplantation (KT) in dialysis patients. We included all patients, who performed hemodialysis (HD) in two dialysis centres between 01.01.2022 and 31.12.2022. The patients were divided into two groups according to history of neoplasia (Neo). We compared patient demographics, hemoglobin levels, anemia treatment, type of VA and the number of patients on the waiting list (WL) for KT. At a second stage of the study, active malignancies were excluded. Statistical analysis included Mann–Whitney U test, Pearson’s χ² test and Fisher exact test. Our study encompassed 139 patients (24 with Neo, in 13 cases it was the cause of CKD). Oncologic patients had higher age (p = 0.048) and similar sex ratio (p > 0.05); had similar hemoglobin levels (p > 0.05), but higher doses of erythropoiesis stimulating agents (ESAs) were needed (p = 0.028); had lower rate of arteriovenous fistulas (AVFs) (p = 0.022), none of them was on the WL for KT. Neo in remission had similar demographics, hemoglobin levels, need for ESAs to the control group (p > 0.05), though lower rate of AVFs was detected (p = 0.017). Malignancy was significant contributor to CKD. Neo patients on HD tended to be older, achieved similar levels of hemoglobin, based on higher ESAs need. Malignancy possibly has influenced the choice of VA and may have limited the chances for KT.