INCIDENCE AND PREDICTORS OF CHRONIC KINDEY DISEASE AMONG PATIENTS WITH PROSTATE CANCER AT MBARARA REGIONAL REFERRAL HOSPITAL

 

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https://storage.unitedwebnetwork.com/files/1099/f7e766d4d5e85d5bb972affa9b2e8d46.pdf
INCIDENCE AND PREDICTORS OF CHRONIC KINDEY DISEASE AMONG PATIENTS WITH PROSTATE CANCER AT MBARARA REGIONAL REFERRAL HOSPITAL

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Fredrick
Bongomin
Fredrick Bongomin fredrickbongomin@gmail.com Mbarara University of Science and Technology Internal Medicine Mbarara Uganda *
Grace Kansiime gkansiime@must.ac.cug Mbarara University of Science an dTechnology Internal Medicine Mbarara Uganda -
Semei Ssekitene sekitene2002@yahoo.com Uganda Cancer Institute Adult Oncology Mbarara Uganda -
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Chronic Kidney Disease (CKD) is a significant comorbidity among patients with prostate cancer (PCa), yet its burden and predictors remain underexplored in resource-limited settings.

We aimed to determine the incidence and predictors of CKD among patients with PCa at Mbarara Regional Referral Hospital (MRRH) in Southwestern Uganda.

A retrospective cohort study was conducted in the oncology unit of MRRH, a satellite center of the Uganda Cancer Institute, and 212 participants with a histologically diagnosed PCa and baseline estimated glomerular filtration rate (eGFR) of equal to or greater than 60 mL/min/1.73 m² who initiated PCa treatment between 2019 and 2022 were enrolled, and their serum creatinines were extracted over a period of 2 years for the development of CKD, defined as an eGFR of less than 60 mL/min/1.73 m² for at least 3 consecutive months as calculated by the CKD-EPI Formula 2021 using at least 2 serial serum creatinine measurements, and an incidence rate and 2-year cumulative incidence were calculated. Cox proportional hazards regression was used to identify predictors of CKD, and a Kaplan-Meier CKD survival curve was plotted in the data analysis software STATA version 17.

The mean (±SD) age of the participants was 73.6 ± 9.9 years, with 89.6%, 29.25 %, 8.49%, and 14.62% having advanced PCa, hypertension, diabetes mellitus, and a prostate-related surgery at

baseline, respectively. The mean (±SD) baseline eGFR, Gleason score, prostate-specific antigen, and hemoglobin were 83.09 ±16.38 mL/min/1.73 m², 8±1, 424.6 ±128.3 ng/dL, and 12.3 ±2.7 g/dL, respectively. 43 participants developed CKD during the study, with a 2-year cumulative incidence of CKD of 20.28% and an overall incidence rate of 11.9 per 1,000 person-months (95% CI: 8.85-16.1).

Multivariable analysis identified hypertension (adjusted hazard ratio [aHR]: 1.90, 95% CI: 1.01-3.60, p=0.048) and anemia defined as hemoglobin of less than 13.0 g/dL (aHR: 2.63, 95% CI: 1.27-5.03, p=0.008 as independent predictors of CKD development.

CKD is a common complication among patients with PCa at MRRH, with hypertension and anemia being significant predictors. Early detection and intensive management of these predictors

may help mitigate CKD progression in this population. Further prospective studies are warranted to develop risk-stratification models and explore other biomarkers of CKD. (Supported by the MUST

Internal Medicine Postgraduate Research Fund. Approval no. MUST-2024-1606). 

Kewords