CKD and Cancer Risk: What's the Link?

Pavankumar Kamat

Disclosures

October 14, 2021

Takeaway

  • Chronic kidney disease (CKD) diagnosed using estimated glomerular filtration rate cystatin C (eGFRcys) was associated with an increased risk of cancer incidence and cancer death.

Why this matters

  • Findings warrant future studies to evaluate the association between kidney function, urinary albumin:creatinine ratio (uACR) and cancer death.

Study design

  • This study included 431,263 participants without a previous diagnosis of cancer, identified from the UK Biobank (2007-2010).

  • The eGFR (mL/min/1.73m2) was evaluated using eGFR creatinine (eGFRcr), eGFRcys and eGFR creatinine-cystatin C.

  • Funding: Chief Scientist Office and others.

Key results

  • Over a median follow-up of 11.3 (interquartile range, 10.6-12.0) years, there were 41,745 cancer incidences and 11,674 cancer deaths.

  • The eGFRcys (per 10 mL/min/1.73mreduction) was associated with an increased risk of cancer incidence (adjusted HR [aHR], 1.04; 95% CI, 1.03-1.04) and cancer death (aHR, 1.10; 95% CI, 1.08-1.11; P<.001).

  • The eGFRcr (per 10 mL/min/1.73mreduction) was not associated with cancer incidence (aHR, 1.00; 95% CI, 1.00-1.01; P=.303) and cancer death (aHR, 0.99; 95% CI, 0.98-1.01; P=.288).

  • Compared with eGFRcys of ≥90 mL/min/1.73m2 or uACR of <3 mg/mmoL, the risk of incident cancer increased with (aHR; 95% CI):

    • eGFRcys 60-89 mL/min/1.73m2 (1.04; 1.02-1.07);

    • eGFRcys <60 mL/min/1.73m2 (1.19; 1.14-1.24); and

    • uACR ≥3 mg/mmoL (1.09; 1.06-1.12; P<.001 for all).

  • Similarly, the risk of cancer death increased with:

    • eGFRcys 60-89 mL/min/1.73m2 (1.15; 1.10-1.21);

    • eGFRcys <60 mL/min/1.73m2 (1.48; 1.38-1.59); and

    • uACR ≥3 mg/mmoL (1.17; 1.11-1.24; P<.001 for all).

Limitations

  • Kidney function was evaluated using a single baseline value of creatinine or cystatin C, with no information on kidney disease progression over time.  

 

Lees JS, Ho F, Parra-Soto S, Celis-Morales C, Welsh P, Sullivan MK, Jani BD, Sattar N, Lang NN, Pell JP, Webster AC, Mark PB. Kidney function and cancer risk: An analysis using creatinine and cystatin C in a cohort study. EClinicalMedicine. 2021;38:101030. doi: 10.1016/j.eclinm.2021.101030. PMID: 34505030  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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