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Background <p>Studies examining the association of chronic kidney disease (CKD) with cancer risk have demonstrated conflicting results.</p> Methods <p>This was an individual participant data meta-analysis including 54 international cohorts contributing to the CKD Prognosis Consortium. Included cohorts had data on albuminuria [urine albumin-to-creatinine ratio (ACR)], estimated glomerular filtration rate (eGFR), overall and site-specific cancer incidence, and established risk factors for cancer. Included participants were aged 18 years or older, without previous cancer or kidney failure.</p> Results <p>Among 1,319,308 individuals, the incidence rate of overall cancer was 17.3 per 1000 person-years. Higher ACR was positively associated with cancer risk [adjusted hazard ratio 1.08 (95% CI 1.06–1.10) per 8-fold increase in ACR]. No association of eGFR with overall cancer risk was seen. For site-specific cancers, lower eGFR was associated with urological cancer and multiple myeloma, whereas higher ACR was associated with many cancer types (kidney, head/neck, colorectal, liver, pancreas, bile duct, stomach, larynx, lung, hemolymphatic, leukaemia, and multiple myeloma). Results were similar in a 1-year landmark analysis.</p> Discussion <p>Albuminuria, but not necessarily eGFR, was independently associated with the subsequent risk of cancer. Our results warrant an investigation into mechanisms that explain the link between albuminuria and cancer.</p>

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Chronic kidney disease and incident cancer risk: an individual participant data meta-analysis

  • 期刊论文

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  • 发表日期：

    2025年9月6日

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  • Yejin Mok,
  • Aditya Surapaneni,
  • Yingying Sang,
  • Josef Coresh,
  • Morgan E. Grams,
  • Kunihiro Matsushita,
  • Shoshana H. Ballew,
  • Natalia Alencar de Pinho,
  • Johan Ärnlöv,
  • Sandhi M. Barreto,
  • Samira Bell,
  • Hermann Brenner,
  • Juan-Jesus Carrero,
  • Rajkumar Chinnadurai,
  • Elizabeth Ciemins,
  • Ron T. Gansevoort,
  • Simerjot K. Jassal,
  • Keum Ji Jung,
  • H. Lester Kirchner,
  • Tsuneo Konta,
  • Csaba P. Kovesdy,
  • Li Luo,
  • Krutika Pandit,
  • Mahboob Rahman,
  • Cassianne Robinson-Cohen,
  • Charumathi Sabanayagam,
  • Ulla T. Schultheiss,
  • Michael Shlipak,
  • Natalie Staplin,
  • Marcello Tonelli,
  • Angela Yee-Moon Wang,
  • Chi-Pang Wen,
  • Mark Woodward,
  • Jennifer S. Lees,
  • Katie Harris,
  • Hisatomi Arima,
  • John Chalmers,
  • Morgan Grams,
  • Elvis Akwo,
  • Jing He,
  • Anita Lloyd,
  • Natalia Alencar de Pinho,
  • Marie Metzger,
  • Bénédicte Stengel,
  • Aghilès Hamroun,
  • Ziad Massy,
  • Panduranga Rao,
  • Giselle Sosa,
  • Vallabh Shah,
  • Jesse Hsu,
  • Alvaro Vigo,
  • José Geraldo Mill,
  • Paulo Lotufo,
  • Scheine Canhada,
  • Ben Schöttker,
  • Hannah Stocker,
  • Dietrich Rothenbacher,
  • Markus P. Schneider,
  • Anna Köttgen,
  • Heike Meiselbach,
  • Kai-Uwe Eckardt,
  • Jamie Green,
  • Alexander R. Chang,
  • Gurmukteshwar Singh,
  • Emilie Lambourg,
  • Shona Livingstone,
  • Colin Palmer,
  • Ewan Pearson,
  • Sun Ha Jee,
  • Heejin Kimm,
  • Ronit Katz,
  • Carina Flaherty,
  • Jeff Mohl,
  • Lyanne M. Kieneker,
  • Stephan JL Bakker,
  • Bert van der Vegt,
  • Rudolf A. de Boer,
  • Jaclyn Bergstrom,
  • Joachim Ix,
  • Keiichi Sumida,
  • Prabin Shrestha,
  • Ching-Yu Cheng,
  • Tien Yin Wong,
  • Pavitra Thyagarajan,
  • William Herrington,
  • Martin J. Landray,
  • Colin Baigent,
  • Philip Kalra,
  • Darren Green,
  • Smeeta Sinha,
  • James Ritchie,
  • Min-Kung Tsai,
  • Jennifer Lees,
  • Anders Larsson,
  • Vilmantas Giedraitis,
  • Andrew S. Levey,
  • Dorothea Nitsch,
  • Michael G. Shlipak

摘要

Background

Studies examining the association of chronic kidney disease (CKD) with cancer risk have demonstrated conflicting results.

Methods

This was an individual participant data meta-analysis including 54 international cohorts contributing to the CKD Prognosis Consortium. Included cohorts had data on albuminuria [urine albumin-to-creatinine ratio (ACR)], estimated glomerular filtration rate (eGFR), overall and site-specific cancer incidence, and established risk factors for cancer. Included participants were aged 18 years or older, without previous cancer or kidney failure.

Results

Among 1,319,308 individuals, the incidence rate of overall cancer was 17.3 per 1000 person-years. Higher ACR was positively associated with cancer risk [adjusted hazard ratio 1.08 (95% CI 1.06–1.10) per 8-fold increase in ACR]. No association of eGFR with overall cancer risk was seen. For site-specific cancers, lower eGFR was associated with urological cancer and multiple myeloma, whereas higher ACR was associated with many cancer types (kidney, head/neck, colorectal, liver, pancreas, bile duct, stomach, larynx, lung, hemolymphatic, leukaemia, and multiple myeloma). Results were similar in a 1-year landmark analysis.

Discussion

Albuminuria, but not necessarily eGFR, was independently associated with the subsequent risk of cancer. Our results warrant an investigation into mechanisms that explain the link between albuminuria and cancer.