Hyponatremia associates with poor outcome in metastatic renal cell carcinoma patients treated with everolimus: prognostic impact

Figures & data

Table 1. Baseline patient characteristics by sodium status.

	Baseline sodium <136 mmol/L(N = 65, 27.9%)	Baseline sodium ≥136 mmol/L(N = 168, 72.1%)	p	Total (N = 233)
	N (%)	N (%)
Age
Median	65.0	65.0	.66	65.0
Range	(24–80)	(39–87)		(24–87)
Gender
Male	49 (75.4)	107 (63.7)	.09	156 (67.0)
Female	16 (24.6)	61 (36.3)		77 (33.0)
Karnofsky performance status
≥80%	42 (64.6)	118 (70.2)	.41	160 (68.7)
<80%	23 (35.4)	50 (29.8)		73 (31.3)
Time from diagnosis to treatment
≥1 year	22 (33.8)	61 (36.3)	.73	83 (35.6)
<1 year	43 (66.2)	107 (63.7)		150 (64.4)
Number of previous treatment lines
1	32 (49.2)	79 (47.0)	.94	111 (47.6)
2	22 (33.8)	61 (36.3)		83 (35.6)
3	11 (16.9)	28 (16.7)		39 (16.7)
Prior nephrectomy
Yes	49 (75.4)	137 (81.5)	.29	186 (79.8)
No	16 (24.6)	31 (18.5)		47 (20.2)
Histology
Clear cell	55 (93.2)	140 (90.3)	.51	195 (91.1)
Nonclear cell	4 (6.8)	15 (9.7)		19 (8.9)
Hemoglobin
≥LLN	20 (30.8)	73 (43.5)	.08	93 (39.9)
<LLN	45 (69.2)	95 (56.5)		140 (60.1)
Albumin corr. Ca
≤ULN	50 (76.9)	127 (77.0)	.99	177 (77.0)
>ULN	15 (23.1)	38 (23.0)		53 (23.0)
Neutrophils
≤ULN	46 (70.8)	147 (87.5)	.002	193 (82.8)
>ULN	19 (29.2)	21 (12.5)		40 (17.2)
Thrombocytes
≤ULN	48 (73.8)	141 (83.9)	.08	189 (81.1)
>ULN	17 (26.2)	27 (16.1)		44 (18.9)
Number of previous treatment lines
1	32 (49.2)	79 (47.0)	.76	111 (47.6)
>1	33 (50.8)	89 (53.0)		122 (52.4)
IMDC
Favorable	5 (7.7)	18 (10.8)	.01	23 (10.0)
Intermediate	23 (35.4)	92 (55.4)		115 (49.8)
Poor	37 (56.9)	56 (33.7)		93 (40.3)

Bold values represent statistically significant at p < .05.

Figure 1. Overall survival for (A) baseline sodium and (B) on-treatment sodium.

Table 2. Multivariate survival analyses with (A) baseline sodium and (B) on-treatment sodium.

Factor	Overall survival		Progression-free survival
	HR (95% CI)	p	HR (95% CI)	p
(A)
Age >65 years			1.29 (0.97–1.71)	.08
IMDC risk classification
Favorable	1.00	<.001	1.00	.003
Intermediate	1.63 (0.94–2.83)	.08	1.42 (0.89–2.29)	.10
Poor	2.67 (1.53–4.68)	.001	2.17 (1.33–3.54)	.002
Baseline sodium < LLN	1.46 (1.04–2.05)	.02	1.12 (0.82–1.53)	.48
Number of previous treatment lines ≥ 2	0.73 (0.54–0.99)	.05	0.90 (0.67–1.19)	.45
(B)
Age >65 years			1.27 (0.95–1.69)	.10
IMDC risk classification
Favorable	1.00	<.001	1.00	.003
Intermediate	1.56 (0.90–2.70)	.09	1.47 (0.91–2.37)	.12
Poor	2.72 (1.55–4.78)	<.001	2.16 (1.32–3.53)	.002
On-treatment sodium < LLN	1.80 (1.23–2.61)	.002	1.71 (1.19–2.46)	.004
Number of previous treatment lines ≥2	0.71 (0.52–0.96)	.03	0.89 (0.67–1.19)	.44

Bold values represent statistically significant at p < .05.

Figure 2. Subgroup analysis among patients with and without baseline hyponatremia and on-treatment hyponatremia or normal sodium; (A) association with overall survival (OS) and (B) association with progression free survival (PFS). LLN: lower limit of normal.