Li Luo, Yuanhang Yang, Lyanne M Kieneker, Roemer J Janse, Alessandro Bosi, Faizan Mazhar, Rudolf A de Boer, Geertruida H de Bock, Ron T Gansevoort, Juan-Jesus Carrero
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Secondary outcomes were site-specific cancer incidence rates. Multivariable Cox proportional hazards regression models adjusted for confounders including eGFR to calculate hazard ratios and 95% confidence intervals (HRs, 95% CIs). Results During a median follow-up of 4.3 (interquartile range 2.0–8.2) years, 21 901 subjects of the ACR cohort developed de novo cancer. In multivariable analyses, adjusting among others for eGFR, subjects with an ACR of 30–299 mg/g or ≥300 mg/g had a 23% (HR 1.23; 95% CI 1.19–1.28) and 40% (HR 1.40; 95% CI 1.31–1.50) higher risk of developing cancer, respectively, when compared with subjects with an ACR <30 mg/g. This graded, independent association was also observed for urinary tract, gastrointestinal tract, lung and hematological cancer incidence (all P < .05). Results were similar in the dipstick albuminuria cohort. Conclusions Albuminuria was associated with the risk of cancer independent of eGFR. This association was primarily driven by a higher risk of urinary tract, gastrointestinal tract, lung and hematological cancers.","PeriodicalId":18987,"journal":{"name":"NDT Plus","volume":"67 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Albuminuria and the risk of cancer: the Stockholm CREAtinine Measurements (SCREAM) project\",\"authors\":\"Li Luo, Yuanhang Yang, Lyanne M Kieneker, Roemer J Janse, Alessandro Bosi, Faizan Mazhar, Rudolf A de Boer, Geertruida H de Bock, Ron T Gansevoort, Juan-Jesus Carrero\",\"doi\":\"10.1093/ckj/sfad145\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"ABSTRACT Background Studies investigating the association of chronic kidney disease and cancer have focused on estimated glomerular filtration (eGFR) rather than on albuminuria. This study aimed to examine whether albuminuria is associated with cancer incidence, and whether this association is independent of eGFR. Methods We included subjects of the Stockholm Creatinine Measurements (SCREAM) project without a history of cancer—250 768 subjects with at least one urine albumin–creatinine ratio (ACR) test (primary cohort) and 433 850 subjects with at least one dipstick albuminuria test (secondary cohort). Albuminuria was quantified as KDIGO albuminuria stages. The primary outcome was overall cancer incidence. Secondary outcomes were site-specific cancer incidence rates. Multivariable Cox proportional hazards regression models adjusted for confounders including eGFR to calculate hazard ratios and 95% confidence intervals (HRs, 95% CIs). Results During a median follow-up of 4.3 (interquartile range 2.0–8.2) years, 21 901 subjects of the ACR cohort developed de novo cancer. In multivariable analyses, adjusting among others for eGFR, subjects with an ACR of 30–299 mg/g or ≥300 mg/g had a 23% (HR 1.23; 95% CI 1.19–1.28) and 40% (HR 1.40; 95% CI 1.31–1.50) higher risk of developing cancer, respectively, when compared with subjects with an ACR <30 mg/g. This graded, independent association was also observed for urinary tract, gastrointestinal tract, lung and hematological cancer incidence (all P < .05). Results were similar in the dipstick albuminuria cohort. Conclusions Albuminuria was associated with the risk of cancer independent of eGFR. 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引用次数: 2
摘要
背景:研究慢性肾脏疾病和癌症相关性的研究主要集中在肾小球滤过(eGFR)的估计上,而不是蛋白尿。本研究旨在探讨蛋白尿是否与癌症发病率相关,以及这种关联是否独立于eGFR。方法纳入无癌症史的斯德哥尔摩肌酐测量(SCREAM)项目的受试者,250 768例至少进行过一次尿白蛋白-肌酐比值(ACR)试验(主要队列),433 850例至少进行过一次尿白蛋白试验(次要队列)。蛋白尿量化为KDIGO蛋白尿分期。主要结果是总体癌症发病率。次要结果是部位特异性癌症发病率。多变量Cox比例风险回归模型校正混杂因素,包括eGFR,计算风险比和95%置信区间(hr, 95% ci)。结果在中位随访4.3年(四分位数间隔2.0-8.2年)期间,ACR队列中有21,901名受试者发生了新发癌症。在多变量分析中,调整eGFR等因素,ACR为30-299 mg/g或≥300 mg/g的受试者有23% (HR 1.23;95% CI 1.19-1.28)和40% (HR 1.40;(95% CI 1.31-1.50),与ACR为30mg /g的受试者相比,患癌症的风险更高。尿路、胃肠道、肺癌和血液学癌症的发病率也观察到这种分级的独立关联(P <. 05)。试纸蛋白尿组的结果相似。结论蛋白尿与癌症风险相关,与eGFR无关。这种关联主要是由泌尿道、胃肠道、肺癌和血液学癌症的高风险引起的。
Albuminuria and the risk of cancer: the Stockholm CREAtinine Measurements (SCREAM) project
ABSTRACT Background Studies investigating the association of chronic kidney disease and cancer have focused on estimated glomerular filtration (eGFR) rather than on albuminuria. This study aimed to examine whether albuminuria is associated with cancer incidence, and whether this association is independent of eGFR. Methods We included subjects of the Stockholm Creatinine Measurements (SCREAM) project without a history of cancer—250 768 subjects with at least one urine albumin–creatinine ratio (ACR) test (primary cohort) and 433 850 subjects with at least one dipstick albuminuria test (secondary cohort). Albuminuria was quantified as KDIGO albuminuria stages. The primary outcome was overall cancer incidence. Secondary outcomes were site-specific cancer incidence rates. Multivariable Cox proportional hazards regression models adjusted for confounders including eGFR to calculate hazard ratios and 95% confidence intervals (HRs, 95% CIs). Results During a median follow-up of 4.3 (interquartile range 2.0–8.2) years, 21 901 subjects of the ACR cohort developed de novo cancer. In multivariable analyses, adjusting among others for eGFR, subjects with an ACR of 30–299 mg/g or ≥300 mg/g had a 23% (HR 1.23; 95% CI 1.19–1.28) and 40% (HR 1.40; 95% CI 1.31–1.50) higher risk of developing cancer, respectively, when compared with subjects with an ACR <30 mg/g. This graded, independent association was also observed for urinary tract, gastrointestinal tract, lung and hematological cancer incidence (all P < .05). Results were similar in the dipstick albuminuria cohort. Conclusions Albuminuria was associated with the risk of cancer independent of eGFR. This association was primarily driven by a higher risk of urinary tract, gastrointestinal tract, lung and hematological cancers.