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Risk of malignancy in patients with chronic kidney disease
Ketki K Tendulkar1, Brendan Cope2, Jianghu Dong1,3
1Division of Nephrology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America.
Plos One
|August 17, 2022
Summary
Chronic kidney disease (CKD) increases cancer risk, particularly with age and worsening kidney function. Early cancer screening is crucial for patients with progressive CKD to improve outcomes.
Area of Science:
- Nephrology
- Oncology
- Epidemiology
Background:
- Chronic kidney disease (CKD) affects 15% of US adults.
- The relationship between CKD and cancer development is not well understood.
- Understanding this link is vital for cancer screening and early detection in CKD patients.
Purpose of the Study:
- To investigate the association between chronic kidney disease (CKD) and the incidence of various malignancies.
- To identify risk factors for cancer development in patients with CKD.
- To explore factors influencing mortality in CKD patients who develop cancer.
Main Methods:
- A retrospective study of 13,750 adult CKD patients (eGFR <60ml/min/1.73m2) from 2001-2020.
- Patients were stratified by CKD stage based on eGFR.
- Multivariable models analyzed cancer incidence, time to cancer, and mortality, adjusting for covariates and considering death as a competing risk.
Main Results:
- 20.1% of CKD patients developed cancer, with a median time of 8.5 years post-diagnosis.
- Increased cancer risk was linked to older age, male sex, and more severe CKD; diabetes showed a protective association.
- Higher mortality in cancer patients was associated with older age, diabetes, and lower eGFR.
Conclusions:
- Chronic kidney disease is an independent risk factor for developing various cancers.
- Aggressive, age-appropriate cancer screening is recommended for individuals with progressive CKD.
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