Imène Mansouri1, Natalia Alencar de Pinho2, Renaud Snanoudj3, Christian Jacquelinet2,4, Mathilde Lassalle4, Clémence Béchade5,6, Cécile Vigneau7,8, Florent de Vathaire1, Nadia Haddy9, Bénédicte Stengel2. 1. University of Paris-Saclay, University of Versailles Saint-Quentin-en-Yvelines, University of Paris-Sud, Inserm, Radiation Epidemiology Team, CESP, Villejuif, France. 2. University of Paris-Saclay, University of Versailles Saint-Quentin-en-Yvelines, University of Paris-Sud, Inserm, Clinical Epidemiology team, CESP, Villejuif, France. 3. Nephrology and Transplantation Department, Foch Hospital, Suresnes, France. 4. Renal Epidemiology and Information Network Registry, Biomedicine Agency, Saint Denis, France. 5. Department of Nephrology, CHU Caen, Caen, France. 6. Nephrology Department, Pontchaillou University Hospital, Rennes, France. 7. Research Institute for Environmental and Occupational Health (IRSET), the French School of Public Health EHESP, INSERM Unit 1085, Rennes University, Rennes, France; and. 8. U1086 INSERM "Anticipe", Center François Baclesse, Caen, France. 9. University of Paris-Saclay, University of Versailles Saint-Quentin-en-Yvelines, University of Paris-Sud, Inserm, Radiation Epidemiology Team, CESP, Villejuif, France; nadia.haddy@gustaveroussy.fr.
Abstract
BACKGROUND AND OBJECTIVES: Cancer survival is improving along with an increase in the potential for adverse kidney effects from antineoplastic treatments or nephrectomy. We sought to describe recent trends in the incidence of kidney failure related to antineoplastic treatments and urinary tract cancers and evaluate patient survival and kidney transplantation access. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used the French Renal Epidemiology and Information Network registry to identify patients with kidney failure related to antineoplastic treatments or urinary tract cancer from 2003 to 2015. We identified 287 and 1157 cases with nephrotoxin- and urinary tract cancer-related kidney failure, respectively. The main study outcomes were death and kidney transplantation. After matching cases to two to ten controls (n=11,678) with other kidney failure causes for age, sex, year of dialysis initiation, and diabetes status, we estimated subdistribution hazard ratios (SHR) of each outcome separately for patients with and without active malignancy. RESULTS: The mean age- and sex-adjusted incidence of nephrotoxin-related kidney failure was 0.43 (95% CI, 0.38 to 0.49) per million inhabitants and 1.80 (95% CI, 1.68 to 1.90) for urinary tract cancer-related kidney failure; they increased significantly by 5% and 2% annually, respectively, during 2006-2015. Compared with matched controls, age-, sex-, and comorbidity-adjusted SHRs for mortality in patients with nephrotoxin-related kidney failure were 4.2 (95% CI, 3.2 to 5.5) and 1.4 (95% CI, 1.0 to 2.0) for those with and without active malignancy, respectively; for those with urinary tract cancer, SHRs were 2.0 (95% CI, 1.7 to 2.2) and 1.1 (95% CI, 0.9 to 1.2). The corresponding SHRs for transplant wait-listing were 0.19 (95% CI, 0.11 to 0.32) and 0.62 (95% CI, 0.43 to 0.88) for nephrotoxin-related kidney failure cases and 0.28 (95% CI, 0.21 to 0.37) and 0.47 (95% CI, 0.36 to 0.60) for urinary tract cancer cases. Once on the waiting list, access to transplantation did not differ significantly between cases and controls. CONCLUSIONS: Cancer-related kidney failure is slowly but steadily increasing. Mortality does not appear to be increased among patients without active malignancy at dialysis start, but their access to kidney transplant remains limited.
BACKGROUND AND OBJECTIVES:Cancer survival is improving along with an increase in the potential for adverse kidney effects from antineoplastic treatments or nephrectomy. We sought to describe recent trends in the incidence of kidney failure related to antineoplastic treatments and urinary tract cancers and evaluate patient survival and kidney transplantation access. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used the French Renal Epidemiology and Information Network registry to identify patients with kidney failure related to antineoplastic treatments or urinary tract cancer from 2003 to 2015. We identified 287 and 1157 cases with nephrotoxin- and urinary tract cancer-related kidney failure, respectively. The main study outcomes were death and kidney transplantation. After matching cases to two to ten controls (n=11,678) with other kidney failure causes for age, sex, year of dialysis initiation, and diabetes status, we estimated subdistribution hazard ratios (SHR) of each outcome separately for patients with and without active malignancy. RESULTS: The mean age- and sex-adjusted incidence of nephrotoxin-related kidney failure was 0.43 (95% CI, 0.38 to 0.49) per million inhabitants and 1.80 (95% CI, 1.68 to 1.90) for urinary tract cancer-related kidney failure; they increased significantly by 5% and 2% annually, respectively, during 2006-2015. Compared with matched controls, age-, sex-, and comorbidity-adjusted SHRs for mortality in patients with nephrotoxin-related kidney failure were 4.2 (95% CI, 3.2 to 5.5) and 1.4 (95% CI, 1.0 to 2.0) for those with and without active malignancy, respectively; for those with urinary tract cancer, SHRs were 2.0 (95% CI, 1.7 to 2.2) and 1.1 (95% CI, 0.9 to 1.2). The corresponding SHRs for transplant wait-listing were 0.19 (95% CI, 0.11 to 0.32) and 0.62 (95% CI, 0.43 to 0.88) for nephrotoxin-related kidney failure cases and 0.28 (95% CI, 0.21 to 0.37) and 0.47 (95% CI, 0.36 to 0.60) for urinary tract cancer cases. Once on the waiting list, access to transplantation did not differ significantly between cases and controls. CONCLUSIONS:Cancer-related kidney failure is slowly but steadily increasing. Mortality does not appear to be increased among patients without active malignancy at dialysis start, but their access to kidney transplant remains limited.
Authors: John T Leppert; Remy W Lamberts; I-Chun Thomas; Benjamin I Chung; Geoffrey A Sonn; Eila C Skinner; Todd H Wagner; Glenn M Chertow; James D Brooks Journal: J Am Soc Nephrol Date: 2017-10-10 Impact factor: 10.121
Authors: Hyune-Ju Kim; Jun Luo; Huann-Sheng Chen; Don Green; Dennis Buckman; Jeffrey Byrne; Eric J Feuer Journal: Stat Med Date: 2017-06-05 Impact factor: 2.373
Authors: J Ferlay; M Colombet; I Soerjomataram; C Mathers; D M Parkin; M Piñeros; A Znaor; F Bray Journal: Int J Cancer Date: 2018-12-06 Impact factor: 7.396