Cancer Linked to Moderate CKD in Older Men
Germaine Wong, MD, of the Centre for Transplant and Renal Research at Westmead Hospital in New South Wales, and colleagues examined the link between moderate CKD and cancer in a population-based cohort of 3,654 individuals aged 49 to 97 years.
During a mean follow-up of 10 years, cancers occurred in 711 subjects (19.5%). For men, the excess risk for cancer began at an estimated glomerular filtration rate (eGFR) of 55 mL/min/1.73 m2. Compared with men who had an eGFR of 55 or higher, those who had an eGFR below 55 had a 39% increased risk of cancer, after adjusting for confounders, the investigators reported in the Journal of the American Society of Nephrology (2009;20:1341-1350).
Men with an eGFR below 40 had a threefold increased risk of cancer compared with men who had an eGFR of 40 or above. In addition, in men, an eGFR below 40 was significantly associated with lung and urinary tract cancers but not prostate, colorectal, or breast cancers, after adjusting for the effect of age, smoking status, sun-related skin damage and diastolic BP.The investigators observed no association between reduced renal function and cancer risk in women.
Noting that the precise biological explanation for the link between decreased renal function and increased cancer risk is unclear, Dr. Wong's group observed:
“Our findings could represent a CKD threshold below which potential uremic factors associated with reduced kidney function increase the risk for cancer independent of other, well-established risk factors, such as iatrogenic immunosuppression used after transplantation.”