CKD Hikes Risk of Cancer, Cancer-Related Death

An eGFR below 45 mL/min/1.73 m2 was associated with a 55% increased risk of death.
An eGFR below 45 mL/min/1.73 m2 was associated with a 55% increased risk of death.

Individuals with a low estimated glomerular filtration rate (eGFR) are at elevated risk for cancer, researchers reported at the National Kidney Foundation's 2014 Spring Clinical Meetings in Las Vegas.

Dhruti Chen, MD, and colleagues at Case Western Reserve University in Cleveland analyzed data from 31,896 participants in a large clinical trial (ALLHAT). After a mean follow-up of 4.9 years, 2,529 individuals had a physician-reported diagnosis of incidence cancer or cancer-related mortality. The 5-year incidence rates were 7.24, 8.38, and 8.29 per 100 person-years among patients with an eGFR above 90 and 60-90 mL/min/1.73 m2, respectively. The rates increased to 9.18 and 11.58 per 100 person-years among those with an eGFR of 45-60 and less than 45, respectively.

The investigators looked at 2 outcomes. Outcome 1 was cancer ascertained by physician-reported cancer incidence or cancer-related mortality during the clinical phase of ALLHAT [Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial]. Outcome 2 was ascertainment of cancer-related death during and after the trial.

For outcome 1, participants with an eGFR below 45 had a 28% increased risk for cancer, respectively, compared with subjects who had an eGFR of 90 or higher, after adjusting for risk factors and other variables.

For outcome 2, 2,338 cancer-related mortalities were reported after a mean follow-up of 8.9 years. Individuals with an eGFR below 45 had a significant 55% increased risk for cancer-related death compared with those who had an eGFR of 90 or higher.

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