BACKGROUND: Acute kidney injury (AKI) is gaining worldwide attention recently, emerging as a major public health threat. However, the association between the development of AKI and subsequent malignancy has not been studied before. METHODS: We conducted a population study based on the Taiwan National Health Insurance database, using 1,000,000 representative database during 2000-2008. All patients' survival to discharge from index hospitalization with recovery from dialysis-requiring AKI were identified (recovery group), and matched with those without recovery and those without AKI, at a 1:1:1 ratio. RESULTS: We identified 625 individuals more than 18 years old [352 male (56.5%); mean age, 63.3 years] in recovery group and matched 625 individuals in each group. During a mean followed-up of 3.7 years, the incidences of new-onset malignancy were 4.2, 2.9, and 2.6 per 100 person-year among the non-recovery, the recovery, and the non-AKI group, respectively. After adjustment, the recovery group was more likely to develop long-term de novo malignancy than those without AKI [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.02-2.03; p = 0.04], while less likely than those who did not recover (HR 0.66, 95% CI 0.45-0.98; p = 0.04). CONCLUSIONS: Dialysis-requiring AKI can post a long-term risk of de novo malignancy for those who survive from the initial insult. Even patients who have recovered from dialysis still carry a significantly higher possibility of developing malignancy than those without AKI episode.
BACKGROUND:Acute kidney injury (AKI) is gaining worldwide attention recently, emerging as a major public health threat. However, the association between the development of AKI and subsequent malignancy has not been studied before. METHODS: We conducted a population study based on the Taiwan National Health Insurance database, using 1,000,000 representative database during 2000-2008. All patients' survival to discharge from index hospitalization with recovery from dialysis-requiring AKI were identified (recovery group), and matched with those without recovery and those without AKI, at a 1:1:1 ratio. RESULTS: We identified 625 individuals more than 18 years old [352 male (56.5%); mean age, 63.3 years] in recovery group and matched 625 individuals in each group. During a mean followed-up of 3.7 years, the incidences of new-onset malignancy were 4.2, 2.9, and 2.6 per 100 person-year among the non-recovery, the recovery, and the non-AKI group, respectively. After adjustment, the recovery group was more likely to develop long-term de novo malignancy than those without AKI [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.02-2.03; p = 0.04], while less likely than those who did not recover (HR 0.66, 95% CI 0.45-0.98; p = 0.04). CONCLUSIONS: Dialysis-requiring AKI can post a long-term risk of de novo malignancy for those who survive from the initial insult. Even patients who have recovered from dialysis still carry a significantly higher possibility of developing malignancy than those without AKI episode.
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Authors: Andrew D Shaw; John A Kellum; John R Prowle; Lui G Forni; Max Bell; Michelle S Chew; Mark Edwards; Morgan E Grams; Michael P W Grocott; Kathleen D Liu; David McIlroy; Patrick T Murray; Marlies Ostermann; Alexander Zarbock; Sean M Bagshaw; Raquel Bartz; Samira Bell; Azra Bihorac; Tong J Gan; Charles E Hobson; Michael Joannidis; Jay L Koyner; Denny Z H Levett; Ravindra L Mehta; Timothy E Miller; Michael G Mythen; Mitra K Nadim; Rupert M Pearse; Thomas Rimmele; Claudio Ronco Journal: Nat Rev Nephrol Date: 2021-05-11 Impact factor: 28.314