Patients with stage 3 or higher chronic kidney disease (CKD) have modestly increased risks of cancer, including prostate cancer in men, compared with patients who have normal kidney function, Hong Xu, MD, PhD, of Karolinska Institutet in Stockholm, and colleagues reported in the Clinical Journal of the American Society of Nephrology.
Among 719,033 Swedes aged 40 years or older with no previous cancer history from the SCREAM (Stockholm Creatinine Measurements) project, investigators detected 64,319 cases of cancer during a median follow-up of 5 years. An estimated glomerular filtration rate (eGFR) of less than 30 or 30 to 59 mL/min/1.73 m2 at baseline was associated with 24% and 8% increased risk of any cancer, respectively, compared with an eGFR reference range of 90 to 104 mL/min/1.73 m2.
Compared with the eGFR reference range, eGFR values less than 30, 30 to 59, and 60 to 89 mL/min/1.73 m2 were associated with a significant 24%, 12%, and 6% increased risk of prostate cancer, respectively, 91%, 56%, and 13% increased risk of urogenital cancer, and 40%, 19%, and 11% increased risk of skin cancer.
According to the team, their results generally agree with comparable studies of CKD patients from the United States and Korea.
“As a practical application, our findings may help healthcare policy makers to develop and implement appropriate strategies for cancer screening and monitoring in the context of CKD as well as help health service planning,” Dr Xu and the team concluded.
The SCREAM project lacked information on tobacco and alcohol use, physical activity, diet, and blood/urine tests, which limits interpretation of the study findings.
Xu H, Matsushita K, Su G, et al. Estimated glomerular filtration rate and the risk of cancer. Clin J Am Soc Nephrol. 2019; published online ahead of print. CJN.10820918. DOI:10.2215/CJN.10820918