Reduced estimated GFR and cancer mortality

Area of Science:

• Nephrology
• Oncology
• Epidemiology

Background:

• Chronic kidney disease is linked to higher cancer incidence.
• The association between reduced kidney function and cancer mortality remains unclear.

Purpose of the Study:

• To evaluate the independent impact of diminished kidney function on cancer-specific mortality.
• To identify specific cancer types most affected by reduced kidney function.

Main Methods:

• A prospective, population-based cohort study involving 4,077 participants (aged 49-97 years) from the Blue Mountains Eye Study.
• Estimated glomerular filtration rate (eGFR) was used to assess kidney function.
• Cancer mortality outcomes were tracked over a median follow-up of 12.8 years.

Main Results:

• A 10-mL/min/1.73 m² decrease in eGFR was associated with an 18% increase in cancer-specific mortality (fully adjusted model, P<0.001).
• Participants with eGFR < 60 mL/min/1.73 m² had a 27% higher risk of cancer mortality compared to those with eGFR ≥ 60 mL/min/1.73 m² (adjusted HR 1.27, P=0.05).
• Elevated cancer mortality risk was site-specific, with significantly higher risks for breast cancer (HR 1.99, P=0.01) and urinary tract cancers (HR 2.54, P=0.04).

Conclusions:

• Reduced kidney function (eGFR < 60 mL/min/1.73 m²) is a significant risk factor for cancer death.
• The increased risk of cancer mortality associated with reduced kidney function varies by cancer site.
• Breast and urinary tract cancers showed the highest mortality risk among individuals with impaired kidney function.