Samuel Iff1, Jonathan C Craig2, Robin Turner3, Jeremy R Chapman4, Jie J Wang5, Paul Mitchell5, Germaine Wong6. 1. Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, New South Wales, Australia; Institute for Social- and Preventive Medicine, University Bern, Bern, Switzerland. 2. Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, New South Wales, Australia; School of Public Health, University of Sydney, New South Wales, Australia. 3. School of Public Health, University of Sydney, New South Wales, Australia. 4. Centre for Transplant and Renal Research, Westmead Hospital, New South Wales, Australia. 5. Centre for Vision Research, Westmead Millennium Institute, Westmead Hospital, New South Wales, Australia. 6. Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, New South Wales, Australia; School of Public Health, University of Sydney, New South Wales, Australia; Centre for Transplant and Renal Research, Westmead Hospital, New South Wales, Australia. Electronic address: germainw@chw.edu.au.
Abstract
BACKGROUND: Chronic kidney disease is associated with an increased risk of cancer, but whether reduced kidney function also leads to increased cancer mortality is uncertain. The aim of our study was to assess the independent effects of reduced kidney function on the risk of cancer deaths. STUDY DESIGN: Prospective population-based cohort study. SETTING & PARTICIPANTS: Participants of the Blue Mountains Eye Study (n=4,077; aged 49-97 years). PREDICTOR: Estimated glomerular filtration rate (eGFR). OUTCOMES: Overall and site-specific cancer mortality. RESULTS: During a median follow-up of 12.8 (IQR, 8.6-15.8) years, 370 cancer deaths were observed in our study cohort. For every 10-mL/min/1.73 m(2) reduction in eGFR, there was an increase in cancer-specific mortality of 18% in the fully adjusted model (P<0.001). Compared with participants with eGFR ≥ 60 mL/min/1.73 m(2), the adjusted HR for cancer-specific mortality for those with eGFR<60 mL/min/1.73 m(2) was 1.27 (95% CI, 1.00-1.60; P=0.05). This excess cancer mortality varied with site, with the greatest risk for breast and urinary tract cancer deaths (adjusted HRs of 1.99 [95% CI, 1.05-3.85; P=0.01] and 2.54 [95% CI, 1.02-6.44; P=0.04], respectively). LIMITATIONS: Residual confounding, such as from unmeasured socioeconomic factors and the potential effects of erythropoiesis-stimulating agents on cancer deaths, may have occurred. CONCLUSIONS: eGFR<60 mL/min/1.73m(2) appears to be a significant risk factor for death from cancer. These effects appear to be site specific, with breast and urinary tract cancers incurring the greatest risk of death among those with reduced kidney function.
BACKGROUND:Chronic kidney disease is associated with an increased risk of cancer, but whether reduced kidney function also leads to increased cancer mortality is uncertain. The aim of our study was to assess the independent effects of reduced kidney function on the risk of cancer deaths. STUDY DESIGN: Prospective population-based cohort study. SETTING & PARTICIPANTS: Participants of the Blue Mountains Eye Study (n=4,077; aged 49-97 years). PREDICTOR: Estimated glomerular filtration rate (eGFR). OUTCOMES: Overall and site-specific cancer mortality. RESULTS: During a median follow-up of 12.8 (IQR, 8.6-15.8) years, 370 cancer deaths were observed in our study cohort. For every 10-mL/min/1.73 m(2) reduction in eGFR, there was an increase in cancer-specific mortality of 18% in the fully adjusted model (P<0.001). Compared with participants with eGFR ≥ 60 mL/min/1.73 m(2), the adjusted HR for cancer-specific mortality for those with eGFR<60 mL/min/1.73 m(2) was 1.27 (95% CI, 1.00-1.60; P=0.05). This excess cancer mortality varied with site, with the greatest risk for breast and urinary tract cancer deaths (adjusted HRs of 1.99 [95% CI, 1.05-3.85; P=0.01] and 2.54 [95% CI, 1.02-6.44; P=0.04], respectively). LIMITATIONS: Residual confounding, such as from unmeasured socioeconomic factors and the potential effects of erythropoiesis-stimulating agents on cancer deaths, may have occurred. CONCLUSIONS: eGFR<60 mL/min/1.73m(2) appears to be a significant risk factor for death from cancer. These effects appear to be site specific, with breast and urinary tract cancers incurring the greatest risk of death among those with reduced kidney function.
Authors: Carolin Grafe; Sabine Semrau; Alexander Hein; Matthias W Beckmann; Andreas Mackensen; Frank Dörje; Martin F Fromm Journal: Naunyn Schmiedebergs Arch Pharmacol Date: 2018-01-02 Impact factor: 3.000
Authors: Germaine Wong; Richard L Hope; Kirsten Howard; Jeremy R Chapman; Antoni Castells; Simon D Roger; Michael J Bourke; Petra Macaskill; Robin Turner; Gabrielle Williams; Wai Hon Lim; Charmaine E Lok; Fritz Diekmann; Nicholas B Cross; Shaundeep Sen; Richard D M Allen; Steven J Chadban; Carol A Pollock; Allison Tong; Armando Teixeira-Pinto; Jean Y H Yang; Narelle Williams; Eric Hoi Kit Au; Anh Kieu; Laura James; Jonathan C Craig Journal: J Am Soc Nephrol Date: 2019-04-30 Impact factor: 10.121
Authors: Germaine Wong; Jade S Hayward; Eric McArthur; Jonathan C Craig; Danielle M Nash; Stephanie N Dixon; Deborah Zimmerman; Abhijat Kitchlu; Amit X Garg Journal: Clin J Am Soc Nephrol Date: 2016-12-29 Impact factor: 8.237