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Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: SA-PO907

Association Between Kidney Function and the Risk of Cancer: Results from the China Health and Retirement Longitudinal Study (CHARLS)

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Liu, Lili, Peking University First Hospital, Beijing, China
  • Meng, Qinqin, Peking University, Beijing, China
  • Wang, Yafeng, Peking University, Beijing, China
  • Zhang, Luxia, Peking University Institute of Nephrology, Beijing, China
  • Zhao, Yaohui, Peking University, Beijing, China
  • Zhao, Ming Hui, Peking University First Hospital, Beijing, China
Background

Increased cancer risk after dialysis or transplantation has been recognized, but studies of cancer in pre-dialysis chronic kidney disease are extremely limited. Therefore, we aim to investigate the risk of cancer in individuals with reduced kidney function.

Methods

Our study was based on a nationally representative sample of population aged 45 years or older from China Health and Retirement Longitudinal Study (CHARLS) conducted between June 2011 and March 2015. Altogether 17,708 participants were randomly chosen using a multistage sampling scheme. For the current analyses, 11,508 eligible individuals with measurement of kidney function and without cancer at baseline were included. Then, 104 participants without follow-up and 392 died of causes unrelated to cancer during follow up were excluded. Estimated glomerular filtration rate (eGFR) was calculated using Chronic Kidney Disease Epidemiological Collaboration equation. Reduced kidney function was defined as eGFR <60 ml/min/1.73m2. Incident cancer cases diagnosed by doctors were documented in the biennial questionnaire of CHARLS. Poisson regression was used to examine the association between kidney function and the risk of cancer.

Results

Altogether 11,012 participants with an average of 58.6 years were included. Participants with eGFR≥90, 60 to 89, and <60 ml/min/1.73m2 accounted for 63.4%, 33.4% and 3.2%, respectively. During 43,854 person-years of follow-up, 217 new cases of cancer were recorded. Compared to participants with eGFR ≥90 ml/min/1.73m2, those with eGFR <60 ml/min/1.73m2 was associated with the increased risk of cancer, with fully adjusted relative risk of 2.04 (95% confidence interval 1.20 to 3.46).

Conclusion

Reduced kidney function is associated with a higher risk of cancer and therefore should be integrated into the risk-stratification of cancer management.

RRs and 95% CIs for cancer risk in different eGFR groups.
eGFR,
ml/min/1.73m2		NumberNo. of caseIncidence rate,
Per 10,0000 person-year		RR (95% CI)aRR (95% CI)bRR (95% CI)c
≥9069791174211 [reference]1 [reference]1 [reference]
59 to 893677795401.28 (0.96, 1.70)1.04 (0.76, 1.43)1.01 (0.73, 1.38)
<603562114893.52 (2.21, 5.60)2.41 (1.43, 4.07)2.04 (1.20, 3.46)

a. Unadjusted; b. Adjusted for age, sex and smoking; c. Adjusted for age, sex, smoking, education, PCE, BMI, drinking, diabetes, hypertension, dyslipidemia and micro-inflammation.