Kidney Week

Abstract: SA-PO0229

Cancer Risk Stratified by Diabetes and Obesity in Patients with CKD: A Nationwide Population-Based Study

Session Information

• Onconephrology: MGRS, HSCT, Electrolytes, RCC, and More
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onconephrology

• 1700 Onconephrology

Authors

• Kim, Chang Seong, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Chang Seong Kim, MD, PhD

• Suh, Sang Heon, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Sang Heon Suh, MD, PhD

• Choi, Hong Sang, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Hong Sang Choi, MD, PhD

• Bae, Eun Hui, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Eun Hui Bae, MD, PhD

• Ma, Seong Kwon, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Seong Kwon Ma, MD, PhD

• Kim, Soo Wan, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Soo Wan Kim, MD, PhD

Background

Diabetes mellitus and obesity have been linked to increased cancer risk in the general population; however, limited evidence exists regarding their association with cancer incidence among patients with chronic kidney disease (CKD). This study aimed to evaluate the impact of glycemic status, body mass index (BMI), and waist circumference (WC) on cancer risk in individuals with CKD.

Methods

We analyzed 1,955,504 adults aged ≥20 years who underwent health checkups from 2012 to 2017 using the Korean National Health Insurance Service database. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m² or the presence of proteinuria. Participants were stratified by glycemic status (normal, impaired fasting glucose [IFG], and diabetes mellitus [DM]), BMI (<18.5, 18.5–23, 23–25, 25–30, ≥30 kg/m²), and sex-specific WC categories. Cancer incidence was tracked over a mean follow-up of 7.3±2.1 years.

Results

During the follow-up, 162,463 incident cancer cases were identified. Compared with individuals with normal glycemic status, those with IFG (adjusted hazard ratio [aHR], 1.025; 95% confidence interval [CI], 1.012–1.037) and DM (aHR, 1.176; 95% CI, 1.162–1.190) showed significantly increased risks of overall cancer. A similar dose-dependent association was observed for higher BMI and WC. Compared with the reference BMI group (18.5–23 kg/m²), the highest BMI group (≥30 kg/m²) had aHR of 1.08. For WC, the highest category (≥100 cm in men/≥95 cm in women) was associated with an aHR of 1.28. Notably, diabetes and elevated BMI or WC were associated with a significantly increased risk of liver and biliary tract cancers. Among female CKD patients, obesity was significantly associated with increased risks of uterine and ovarian cancers. A subgroup analysis showed that CKD patients with both diabetes and BMI ≥30 kg/m² had a higher cancer risk (aHR 1.23) compared to non-diabetic patients with normal BMI. Likewise, greater waist circumference in diabetics was linked to increased cancer risk (up to aHR 1.32).

Conclusion

Diabetes and obesity are associated with an elevated risk of total cancer among individuals with CKD, particularly hepatobiliary malignancies. Diabetes and obesity exert a combined effect on cancer risk in CKD.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025qqs79753