Risk of cancer in pre-dialysis chronic kidney disease: A nationwide population-based study with a matched control group

Park, Sehoon; Lee, Soo Jin; Kim, Yaerim; Lee, Yeonhee; Kang, Min Woo; Han, Kyungdo; Han, Seoung Seok; Lee, Hajeong; Lee, Jung Pyo; Joo, Kwon Wook; Lim, Chun Soo; Kim, Yon Su

doi:10.23876/j.krcp.18.0131

Cited by 35 publications

(38 citation statements)

References 34 publications

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“…In a previous Korean cohort study, the CKD group demonstrated an increased risk of urinary tract malignancies compared with the general population (IR 9.4 per 10,000 vs IR 4.6 per 10,000) 10 . In the 2015 annual report of the Korean National Cancer Institute, the crude IR for urinary tract cancer was 1.68 per 10,000 21 .…”

Section: Discussionmentioning

confidence: 85%

Epidemiological characteristics of cancers in patients with end-stage kidney disease: a Korean nationwide study

Lee

Park

et al. 2021

Sci Rep

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Patients with end-stage kidney disease (ESKD) have been reported to have an increased risk of cancer. However, the epidemiological characteristics of cancer in ESKD patients remain unclear. Therefore, this study aimed to investigate the epidemiological characteristics of cancer in ESKD patients and the differences based on the renal replacement therapy provided. Data on ESKD patients were obtained from the South Korean nationwide cohort Health Insurance Review and Assessment Service database. This study included 58,831 eligible patients of the total 813,907 patients diagnosed with ESKD between January 1, 2007 and December 31, 2017. Of the 58,831 ESKD patients, 3292 (5.6%) were newly diagnosed with cancer. The average duration between the diagnosis of ESKD and cancer was 3.3 ± 1.9 years (mean ± standard deviation), with no differences between hemodialysis, peritoneal dialysis, and kidney transplant groups. The most commonly observed cancer sites in ESKD patients were the colorectum, lung, and liver. The incidence of cancer increased progressively among patients undergoing kidney transplant, peritoneal dialysis, and hemodialysis in that order. Hemodialysis patients were found to have an increased risk of digestive tract cancer compared with kidney transplant patients (adjusted hazard ratio = 1.9; 95% confidence interval: 1.31–2.81; P < 0.001). The study findings may be a useful reference for cancer-screening guidelines.

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Section: Discussionmentioning

confidence: 85%

Epidemiological characteristics of cancers in patients with end-stage kidney disease: a Korean nationwide study

Lee

Park

et al. 2021

Sci Rep

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“…Furthermore, the proportion of the patients who deteriorated their CKD stage and who progressed to ESKD were higher in the more advanced AKI group, although its absolute ESKD incidence was rare. The relationship between cancer and kidney seems to be a circular, but previous studies usually limited to acute kidney damage in cancer patients or cancer development in CKD patients [25,26]. By virtue of the recent advancement in early detection and cancer treatment, the numbers of cancer survivors are increasing.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Acute Kidney Injury in Lung Cancer Patients

et al. 2021

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Acute kidney injury (AKI) in cancer patients is associated with increased morbidity and mortality. The incidence of AKI in lung cancer seems to be relatively higher compared with other solid organ malignancies, although its impact on patient outcomes remains unclear. Materials and MethodsThe patients newly diagnosed with lung cancer from 2004 to 2013 were enrolled in this retrospective cohort study. The patients were categorized according to the presence and severity of AKI. We compared all-cause mortality and long-term renal outcome according to AKI stage. ResultsA total of 3,202 patients were included in the final analysis. AKI occurred in 1,783 (55.7%) patients during the follow-up period, with the majority having mild AKI stage 1 (75.8%).During the follow-up of 2.6 ± 2.18 years, total 1,251 (53.7%) patients were died and 5-yr survival rate was 46.9%. We found that both AKI development and severity were independent risk factors for all-cause mortality in lung cancer patients, even after adjustment for lung cancerspecific variables including the stage or pathological type. In addition, patients suffered from more severe AKI tend to encounter de novo CKD development, worsening kidney function, and end-stage kidney disease progression. ConclusionIn this study, more than half of the lung cancer patients experienced AKI during their diagnosis and treatment period. Moreover, AKI occurrence and more advanced AKI were associated with a higher mortality risk and adverse kidney outcomes.

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“…Higher phosphate concentrations in men are related to a higher overall cancer risk ( Wulaningsih et al, 2013 ), and higher phosphate intake accelerates tumorigenesis in mice ( Lee et al, 2015 ), uncovering phosphate as a possible factor in cancer ( Brown and Razzaque, 2018 ). Accordingly, CKD patients, often exhibiting hyperphosphatemia and 1,25(OH) 2 D 3 deficiency, have an increased risk of cancer ( Wong et al, 2009 , 2016 ; Park et al, 2019 ). 1,25(OH) 2 D 3 may have anti-cancer activity ( Vanoirbeek et al, 2011 ).…”

Section: Fgf23/kl Phosphate Homeostasis and Cancermentioning

confidence: 99%

Role of Fibroblast Growth Factor 23 (FGF23) and αKlotho in Cancer

Ewendt

Feger

Föller

2021

Front. Cell Dev. Biol.

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Together with fibroblast growth factors (FGFs) 19 and 21, FGF23 is an endocrine member of the family of FGFs. Mainly secreted by bone cells, FGF23 acts as a hormone on the kidney, stimulating phosphate excretion and suppressing formation of 1,25(OH)2D3, active vitamin D. These effects are dependent on transmembrane protein αKlotho, which enhances the binding affinity of FGF23 for FGF receptors (FGFR). Locally produced FGF23 in other tissues including liver or heart exerts further paracrine effects without involvement of αKlotho. Soluble Klotho (sKL) is an endocrine factor that is cleaved off of transmembrane Klotho or generated by alternative splicing and regulates membrane channels, transporters, and intracellular signaling including insulin growth factor 1 (IGF-1) and Wnt pathways, signaling cascades highly relevant for tumor progression. In mice, lack of FGF23 or αKlotho results in derangement of phosphate metabolism and a syndrome of rapid aging with abnormalities affecting most organs and a very short life span. Conversely, overexpression of anti-aging factor αKlotho results in a profound elongation of life span. Accumulating evidence suggests a major role of αKlotho as a tumor suppressor, at least in part by inhibiting IGF-1 and Wnt/β-catenin signaling. Hence, in many malignancies, higher αKlotho expression or activity is associated with a more favorable outcome. Moreover, also FGF23 and phosphate have been revealed to be factors relevant in cancer. FGF23 is particularly significant for those forms of cancer primarily affecting bone (e.g., multiple myeloma) or characterized by bone metastasis. This review summarizes the current knowledge of the significance of FGF23 and αKlotho for tumor cell signaling, biology, and clinically relevant parameters in different forms of cancer.

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Risk of cancer in pre-dialysis chronic kidney disease: A nationwide population-based study with a matched control group

Cited by 35 publications

References 34 publications

Epidemiological characteristics of cancers in patients with end-stage kidney disease: a Korean nationwide study

Epidemiological characteristics of cancers in patients with end-stage kidney disease: a Korean nationwide study

Clinical Significance of Acute Kidney Injury in Lung Cancer Patients

Role of Fibroblast Growth Factor 23 (FGF23) and αKlotho in Cancer

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