One in Five With CKD Developed Cancer

By Leah Lawrence - Last Updated: September 7, 2022

Chronic kidney disease (CKD) was a risk factor for developing various malignancies, according to a single institution study published in PLoS One.

According to the study, 15% of U.S. adults have CKD but the effect of CKD on development of malignancies is currently unknown.

In this study, the researchers analyzed 13,750 patients with CKD diagnosed between January 2001 and December 2020 at a single institution. Over a follow-up of about 20 years, 20.1% of these patients developed a malignancy. Median age at cancer diagnosis was 71 years.

“This number is higher than the reported lifetime risk of cancer in the general population in this age group,” the researchers wrote. “The lifetime risk of developing a cancer is one in 16 in both males and females between the ages of 50 and 60 years, while the risk in patients between the ages of 60 and 69 years is 1 in 7 in males and 1 in 10 in females.”

The common cancers diagnosed included gastrointestinal malignancies, prostate, other urinary tract malignancies, thoracic cancers, breast cancer, head and neck cancer, gynecologic malignancies, and hematologic malignancies. The median time from CKD diagnosis to development of cancer was 8.5 years.

Some of the factors associated with risk for developing cancer in patients with CKD included male sex, increasing age, and worsening CKD. Additionally, compared with patients younger than 50, patients 80 or older were more likely to develop malignancy (HR=3.34; 95% CI, 2.89-3.88).

Those patients with a baseline eGFR of less than 30 mL/min/1.73m2 were 1.5 times more likely to develop a malignancy than patients who had an eGFR of greater than 60.

The researchers also looked at factors associated with increased mortality in patients who developed cancer, which included increasing age, presence of diabetes, and lower eGFR.

Because the study was only at a single institution, the researchers wrote that the results need to be confirmed in other settings.

“However, given the large cohort of patients and the long follow-up duration, these findings appear to be robust,” they noted. “The mechanisms for this increased risk should be investigated further. More importantly, age-appropriate cancer screening should be aggressively pursued in patients with progressive CKD.”

 

Reference

Risk of malignancy in patients with chronic kidney disease

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