Relationship Between Mortality and Cancer‐Bearing Status in Patients With Chronic Kidney Disease Who Attended an Educational Program

Abstract

Patients with malignancy have a poorer prognosis than others do, which must be taken into consideration when treating them for chronic kidney disease (CKD). However, there are few studies investigating their prognosis. This was an observational study of 515 (394 men and 121 women) stable non-dialysis patients with CKD who attended a CKD educational program. Mean age was 68.8 ± 13.0 years. Median follow-up was 968.5 days. Mean creatinine was 3.4 ± 1.6 mg/dL. Of these, 63 had malignancy and 452 did not; 20.6% of the former and 11.9% of the latter group died by the end of the study period (P = 0.0548). Malignancy was not associated with allcause mortality (HR: 1.3475, 95% CI: 0.7202-2.5214, P = 0.3507) but with malignancy-associated mortality (HR: 3.9477, 95% CI: 1.6348-9.5331, P = 0.0023). Renal replacement therapy was not associated with mortality. Since malignancy greatly affects the prognosis, it must be taken into consideration when treating these patients.

Risks of female genital tract related cancers (gynecological cancers) or breast cancer in women with and without chronic kidney disease

“…Patients with CKD are often stated in the immunosuppressive status. [ 6 – 11 , 27 ] The CKD women might impair the ability to eradicate human papilloma virus (HPV) infection when they got infection. In addition, these CKD women subsequently may have a prolonged latency of HPV infection or persistent HPV infection, which is a key factor for the development of cervical pre-cancer lesions and cancers in women.…”

“…The most important strength of the current study was unlikely to the well-known higher risk of upper tract urothelial carcinoma in the CKD women in the world, including Taiwan, [ 6 , 16 , 20 – 26 , 69 ] and it might be the first nationwide, population-based study to investigate the risk of GC in the CKD women in Asia. In addition, using this national population-based study, we further confirmed that GC is an age-dependent disease.…”

“…[ 2 – 5 ] In patients with chronic kidney disease (CKD), impairment of immune system, impairment of DNA repair, reduced clearance of toxic or carcinogenic compounds, and increased infection and chronic inflammation, are in theory related to development of cancer. [ 6 – 11 ] CKD is defined as kidney damage or decreased kidney function [glomerular filtration rate (GFR) lower than 60 mL/min per 1.73 m 2 ] for 3 months or longer. [ 12 – 14 ] The prevalence and incidence of CKD is significantly increasing in decades.…”

“…For the majority of women with CKD, most of whom might have much comorbidity, it is rationale to suppose that these CKD women have limited life expectancy, contributing to neglecting cancer screening. However, studies from different countries have found that the incidence rate (IR) of cancers varied greatly in the CKD patients, [ 6 , 11 , 20 – 31 ] and some reports showed that cancer IR in the CKD patients was higher than that in the general population. [ 6 , 11 ] Among these studies, most found that these CKD patients had a higher risk of urinary tract system cancers.…”

“…However, studies from different countries have found that the incidence rate (IR) of cancers varied greatly in the CKD patients, [ 6 , 11 , 20 – 31 ] and some reports showed that cancer IR in the CKD patients was higher than that in the general population. [ 6 , 11 ] Among these studies, most found that these CKD patients had a higher risk of urinary tract system cancers. [ 31 ] Except the increased risk of urinary tract cancers, cancer risk from the other organs in women is not consistent.…”