Risk of cancer in pre-dialysis chronic kidney disease: A nationwide population-based study with a matched control group
- Authors
- Park S.; Lee S.; Kim Y.; Lee Y.; Kang M.W.; Han K.; Han S.S.; Lee H.; Lee J.P.; Joo K.W.; Lim C.S.; Kim Y.S.; Kim D.K.
- Issue Date
- Mar-2019
- Publisher
- The Korean Society of Nephrology
- Keywords
- Cancer; Chronic kidney disease; Comorbidity; Epidemiology; Neoplasms
- Citation
- Kidney Research and Clinical Practice, v.38, no.1, pp.60 - 70
- Journal Title
- Kidney Research and Clinical Practice
- Volume
- 38
- Number
- 1
- Start Page
- 60
- End Page
- 70
- URI
- http://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/39062
- DOI
- 10.23876/j.krcp.18.0131
- ISSN
- 2211-9132
- Abstract
- Background: Cancer risk and epidemiology in pre-dialysis chronic kidney disease (CKD) warrant further investigation in a large-scale cohort. Methods: We performed a nationwide population-based study using the national health insurance database of Korea. We screened records from 18,936,885 individuals who received a national health examination ≥ 2 times from 2009 to 2016. Pre-dialysis CKD was identified based on serum creatinine and dipstick albuminuria results. Individuals with preexisting cancer history, renal replacement therapy, or transient CKD were excluded. A control group without evidence of kidney function impairment and matched for age, sex, low-income status, and smoking history was included. Risk of cancers, as identified in the claims database, was investigated using a multivariable Cox regression model including matched variables and other unmatched clinical characteristics as covariates. Results: A total of 471,758 people with pre-dialysis CKD and the same number of matched controls were included. Urinary (adjusted hazard ratio [HR], 1.97; 95% confidence interval [95% CI], 1.82-2.13) and hematopoietic (adjusted HR, 1.53; 95% CI, 1.38-1.68) malignancy risk was increased in pre-dialysis CKD and all CKD stages. However, the risk of digestive cancer was lower in the pre-dialysis CKD group (adjusted HR, 0.89; 95% CI, 0.87-0.92). The risk of digestive, respiratory, thyroid, and prostate malignancy demonstrated a non-linear association with CKD stage, with stage 1 or stage 4/5 CKD without dialysis demonstrating relatively lower risk. Conclusion: Cancer risk varied in pre-dialysis CKD compared to controls, and the association between cancer risk and CKD stage varied depending on the cancer type. © 2019 by The Korean Society of Nephrology.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - ETC > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.