Abstract: FR-PO528

Independent Associations of eGFR and Albuminuria with Cancer Incidence

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Mok, Yejin, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Ballew, Shoshana, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Sang, Yingying, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Coresh, Josef, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Joshu, Corinne, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Platz, Elizabeth A., Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Matsushita, Kunihiro, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
Background

Cancer is a potential complication of chronic kidney disease (CKD) recently attracting attention. However, no previous studies have simultaneously investigated two key CKD measures, estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR), for the risk of cancer incidence.

Methods

In 9,191 participants without prevalent cancer from the Atherosclerosis Risk in Communities (ARIC) study in 1996 to 1998, the associations of eGFR (based on creatinine and cystatin C) and ACR with overall and site-specific cancer incidence were evaluated with Cox proportional hazards model adjusted for conventional lifestyle and clinical risk factors for CKD and/or cancer.

Results

During a median follow-up of 14.7 years, 2,063 incident cancer cases occurred in 117,420 person years. eGFR was not associated with total cancer incidence after adjusting for risk factors. ACR was possibly positively associated after adjustment for age, sex, and race, but further adjustment for other potential confounders attenuated the association. By cancer site, a higher ACR was significantly associated with increased risk of lung and hematopoietic cancers (hazard ratio per 8-fold higher ACR was 1.29 [1.08-1.53] and 1.27 [1.02-1.59], respectively). The results were consistent for lung cancer even after excluding cancer in the first three years. These results were largely consistent in subgroups of sex, race, and current smoking status.

Conclusion

Kidney measures, particularly higher albuminuria, were modestly associated with cancer incidence. The association of ACR was especially robust for lung cancer and this finding is consistent with previous studies. Mechanisms underlying this association are not clear, and further studies exploring potential mechanism are needed.

Funding

  • Other NIH Support