Estimated glomerular filtration rate and the risk of cancer

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Estimated glomerular filtration rate and the risk of cancer

Xu, Hong (author): Karolinska Institutet

Matsushita, Kunihiro (author)

Su, Guobin (author): Karolinska Institutet

Trevisan, Marco (author): Karolinska Institutet

Ärnlöv, Johan, 1970- (author): Högskolan Dalarna,Medicinsk vetenskap,Karolinska Institutet

Barany, Peter (author): Karolinska Institutet

Lindholm, Bengt (author): Karolinska Institutet

Elinder, Carl-Gustaf (author): Karolinska Institutet

Lambe, Mats (author): Karolinska Institutet

Carrero, Juan-Jesus (author): Karolinska Institutet

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(creator_code:org_t)

2019
2019
English.
In: American Society of Nephrology. Clinical Journal. - 1555-9041 .- 1555-905X. ; 14:4, s. 530-539

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.2...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND AND OBJECTIVES: Community-based reports regarding eGFR and the risk of cancer are conflicting. We here explore plausible links between kidney function and cancer incidence in a large Scandinavian population-based cohort.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In the Stockholm Creatinine Measurements project, we quantified the associations of baseline eGFR with the incidence of cancer among 719,033 Swedes ages ≥40 years old with no prior history of cancer. Study outcomes were any type and site-specific cancer incidence rates on the basis of International Classification of Diseases-10 codes over a median follow-up of 5 years. To explore the possibility of detection bias and reverse causation, we divided the follow-up time into different time periods (≤12 and >12 months) and estimated risks for each of these intervals.RESULTS: In total, 64,319 cases of cancer (affecting 9% of participants) were detected throughout 3,338,226 person-years. The relationship between eGFR and cancer incidence was U shaped. Compared with eGFR of 90-104 ml/min, lower eGFR strata associated with higher cancer risk (adjusted hazard ratio, 1.08; 95% confidence interval, 1.05 to 1.11 for eGFR=30-59 ml/min and adjusted hazard ratio, 1.24; 95% confidence interval, 1.15 to 1.35 for eGFR<30 ml/min). Lower eGFR strata were significantly associated with higher risk of skin, urogenital, prostate, and hematologic cancers. Any cancer risk as well as skin (nonmelanoma) and urogenital cancer risks were significantly elevated throughout follow-up time, but they were higher in the first 12 months postregistration. Associations with hematologic and prostate cancers abrogated after the first 12 months of observation, suggesting the presence of detection bias and/or reverse causation.CONCLUSIONS: There is a modestly higher cancer risk in individuals with mild to severe CKD driven primarily by skin and urogenital cancers, and this is only partially explained by bias.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)

Keyword

Bias
Cancer
Confidence Intervals
Follow-Up Studies
Hematologic Neoplasms
Incidence
International Classification of Diseases
Proportional Hazards Models
Prostatic Neoplasms
Renal Insufficiency
Chronic
Risk
Urogenital Neoplasms
chronic kidney disease
detection bias
estimated glomerular filtration rate
glomerular filtration rate
reverse causation
Hälsa och välfärd
Health and Welfare

Publication and Content Type

ref (subject category)
art (subject category)

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By the author/editor: Xu, Hong; Matsushita, Kuni ...; Su, Guobin; Trevisan, Marco; Ärnlöv, Johan, 1 ...; Barany, Peter; show more...; Lindholm, Bengt; Elinder, Carl-Gu ...; Lambe, Mats; Carrero, Juan-Je ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...

Articles in the publication: American Society ...

By the university: Högskolan Dalarna; Karolinska Institutet

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