Risk of cancer in pre-dialysis chronic kidney disease: A nationwide population-based study with a matched control group
Kidney Research and Clinical Practice
; : 60-70, 2019.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-758974
Responsible library:
WPRO
ABSTRACT
BACKGROUND:
Cancer risk and epidemiology in pre-dialysis chronic kidney disease (CKD) warrant further investigation in a large-scale cohort.METHODS:
We performed a nationwide population-based study using the national health insurance database of Korea. We screened records from 18,936,885 individuals who received a national health examination ≥ 2 times from 2009 to 2016. Pre-dialysis CKD was identified based on serum creatinine and dipstick albuminuria results. Individuals with preexisting cancer history, renal replacement therapy, or transient CKD were excluded. A control group without evidence of kidney function impairment and matched for age, sex, low-income status, and smoking history was included. Risk of cancers, as identified in the claims database, was investigated using a multivariable Cox regression model including matched variables and other unmatched clinical characteristics as covariates.RESULTS:
A total of 471,758 people with pre-dialysis CKD and the same number of matched controls were included. Urinary (adjusted hazard ratio [HR], 1.97; 95% confidence interval [95% CI], 1.82–2.13) and hematopoietic (adjusted HR, 1.53; 95% CI, 1.38–1.68) malignancy risk was increased in pre-dialysis CKD and all CKD stages. However, the risk of digestive cancer was lower in the pre-dialysis CKD group (adjusted HR, 0.89; 95% CI, 0.87–0.92). The risk of digestive, respiratory, thyroid, and prostate malignancy demonstrated a non-linear association with CKD stage, with stage 1 or stage 4/5 CKD without dialysis demonstrating relatively lower risk.CONCLUSION:
Cancer risk varied in pre-dialysis CKD compared to controls, and the association between cancer risk and CKD stage varied depending on the cancer type.
Full text:
Available
Health context:
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
Health problem:
Goal 9: Noncommunicable diseases and mental health
/
Target 3.4: Reduce premature mortality due to noncommunicable diseases
Database:
WPRIM (Western Pacific)
Main subject:
Prostate
/
Smoke
/
Thyroid Gland
/
Smoking
/
Comorbidity
/
Epidemiology
/
Cohort Studies
/
Renal Replacement Therapy
/
Creatinine
/
Dialysis
Type of study:
Etiology study
/
Incidence study
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Observational study
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Prognostic study
/
Risk factors
Country/Region as subject:
Asia
Language:
English
Journal:
Kidney Research and Clinical Practice
Year:
2019
Document type:
Article