Am J Epidemiol. 2021 May 12:kwab140. doi: 10.1093/aje/kwab140. Online ahead of print.
ABSTRACT
Chronic kidney disease in its later stages is associated with increased kidney cancer risk. We investigated whether chronic kidney disease at milder stages is associated with increased risk of kidney cancer, using a retrospective cohort of 9,809,317 adults in Republic of Korea who participated in a nationwide health screening (2009-2016). We examined the impact of estimated glomerular filtration rate (eGFR), dipstick proteinuria, and interactive associations of the two factors on the risk of incident kidney cancer. During a median follow-up of 7.3 years, 10,634 kidney cancers were identified. After adjustment for multiple confounders, participants with reduced eGFR were associated with an increased risk of kidney cancer (adjusted hazard ratio = 1.18, 95% confidence interval: 1.01, 1.39 for eGFR <30; adjusted hazard ratio = 1.22, 95% confidence interval: 1.14, 1.31 for eGFR 30-58), compared to those with eGFR of 60-89mL/min/1.73m2. A dose-response relationship was observed between the severity of proteinuria and incident kidney cancer. Analyses of joint effects of eGFR and dipstick proteinuria showed that with the presence of proteinuria, the kidney cancer incidence was markedly increased along with decreasing eGFR. Reduced eGFR and proteinuria are significantly associated with subsequent risk of kidney cancer, possibly in a synergistic manner.
PMID:33984862 | DOI:10.1093/aje/kwab140
