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Abstract: PO1902

Nephrotic Syndrome as a Paraneoplastic Entity

Session Information

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Valencia-Morales, Nancy Daniela, Hospital Clinico Universitario San Carlos, Madrid, Madrid, Spain
  • García-Carro, Clara, Hospital Clinico Universitario San Carlos, Madrid, Madrid, Spain
  • León Román, Juan, Vall d'Hebron Hospital Universitari, Barcelona, Catalunya, Spain
  • Soler, Maria Jose, Vall d'Hebron Hospital Universitari, Barcelona, Catalunya, Spain
  • Aiffil-Meneses, Arianne, Hospital Clinico Universitario San Carlos, Madrid, Madrid, Spain
  • Sanchez de la Nieta Garcia, Maria Dolores, Hospital Clinico Universitario San Carlos, Madrid, Madrid, Spain
  • Rodriguez, Antolina, Hospital Clinico Universitario San Carlos, Madrid, Madrid, Spain
  • Velo, Mercedes L., Hospital Clinico Universitario San Carlos, Madrid, Madrid, Spain
  • Valdés-Francí, Elena, Hospital Clinico Universitario San Carlos, Madrid, Madrid, Spain
  • Sanchez fructuoso, Ana, Hospital Clinico Universitario San Carlos, Madrid, Madrid, Spain
Background

Association between nephrotic syndrome (NS) and cancer is known but it has been barely studied. Membranous nephropathy (MN) has been identified as a paraneoplastic disease. Incidence of cancer at the time of biopsy of MN is 10-20%. Rates in other glomerulopathies are limited. Concomitant malignancy is associated with poor outcome in NS: cancer therapy is a priority and immunosuppression for NS should be restricted. There is no consensus for cancer screening in patients with NS, with or without known risk factors.
Aim: To establish the incidence of cancer in a cohort of patients with NS onset & to analyze clinical & histologic characteristics, type and risk factors for cancer.

Methods

All patients with NS at one hospital in Madrid between 1/2013-12/2019 and all patients with NS at one hospital in Barcelona between 1/2018- 6/2020 were included. Demographical, clinical and laboratory data were recorded. Patients who presented cancer 1 year before or 2 years after NS onset were identified. A logistic regression model was performed to identify risk factors for cancer.

Results

114 patients presented with NS during the study periods. 57% men, mean age 57.3±17.3. 60% presented high blood pressure, 36% DM2, 7% HIV, and 6% hepatitis C. 44.7% reported smoking, and 13.1% alcohol consumption. More frequent histologic diagnosis: diabetic nephropathy (17.5%), MN (14.9%), minimal change disease (7.9%), membranoproliferative glomerulonephritis (7.9%). 8 patients presented anti phospholipase A2 receptor antibodies. 17.5% patients presented cancer: 12 patients 1 year before the NS onset (10 solid organ, 2 haematological cancer), and 8 patients 2 years after NS onset (3 solid organ, 5 haematological cancer). Patients with cancer were older (72.3±10.3 vs 53.2±17.1, p<0.0001). No differences in smoking, viral infections, renal function, proteinuria or glomerulopathy. Multivariate analysis showed age as the only risk factor for cancer (OR 1.122, IC 95% 1.050-1.1980; p=0.0007).

Conclusion

In our cohort, 17.5 % patients with NS presented also concomitant cancer. Age was the only risk factor for neoplasia. No association between cancer and gender, type of glomerulopathy, or known risk factors for neoplasia as alcohol, tobacco or viral infection was found.