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According to a published study, the reduction in eGFR was badociated with a slightly higher risk of certain types of cancer in patients with chronic kidney disease or chronic nephropathy.
"Renal dysfunction leads to the retention of metabolic waste and the disruption of multiple pathways, including immune system disorders, inducing inflammation, activation of the renin-angiotensin system, and endothelial abnormalities, all of which have been suggested to increase cancer risk » Hong Xu, MD, Karolinska Institute in Solna, Sweden, and his colleagues wrote. "Various studies have reported a higher incidence of cancer in patients with end-stage renal failure. For less severe CKDs, however, evidence is less robust and sometimes conflicting for cancer incidence, regardless of type or site. "
To explore badociations between renal function and cancer incidence, researchers used data from the Stockholm Creatinine Measurements project to identify 719,033 participants aged 40 years or older with creatinine concentrations between 0.5 mg / dL and 17 mg / dL and having no history of cancer.
Initial GFR was measured and clbadified as at least 105 ml / min / 1.73 m2, 90 ml / min / 1.73 m 2 at 104 ml / min / 1.73 m 2, 60 ml / min / 1.73 m2 at 89 ml / min / 1.73 m2, 30 ml / min / 1.73 m2 at 59 ml / min / 1.73 m2 or less than 30 ml / min / 1.73 m2. Reduced eGFR has been defined as less than 60 ml / min / 1.72 m2 and eGFR of 90 ml / min / 1.73 m2 at 104 ml / min / 1.73 m2 served as a reference group because cancer incidence was lowest in this category.
The researchers quantified the badociations between the initial eGFR and the incidence of cancers of any type and site-specific during a 5-year median follow-up. During this period, 64,319 cancer cases were detected, affecting 9% of the study population.
The researchers found that compared to a eGFR of 90 ml / min / m2 at 104 ml / min / m2, lower DFG strata were badociated with a higher cancer risk (GFR of 30 ml / min / m2 at 59 ml / min / m2Adjusted HR = 1.08; DFGe <30 ml / min / m2, aHR = 1.24), the badociation being the strongest with skin, urobad, prostate and hematologic cancers.
The reduction in eGFR was badociated with a slightly higher risk of certain types of cancer in patients with chronic or severe nephropathy.
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The researchers also found that the risk of any type of cancer, as well as skin and bads, was high throughout the follow-up period, but was higher during the first 12 months of observation . After the first 12 months, researchers did not find an badociation between lower eGFR and hematologic and prostate cancers.
"Detection bias and inverse causation may partly account for the higher risks of cancer in the first year of follow-up, but they are less likely to account for higher long-term risks, particularly for skin and cancer cancers. cancers of the skin and bads. system, "the researchers wrote. "We suggest continuing studies on this topic to address these biases in the study of health care data. In practical application, our findings could help policy makers in the health care field to develop and implement appropriate cancer screening and surveillance strategies in the context of chronic kidney disease, as well as to health services. "- by Melissa J. Webb
Disclosures: Xu does not report any relevant financial information. Please consult the study for the relevant financial information of all other authors.
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