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Chronic Kidney Disease May Up Risks For Kidney, Urothelial Cancers – Renal And Urology News – Renal.PlatoHealth.ai

Patients with nondialysis-dependent chronic kidney disease (CKD) have increased risks for kidney cancer and urothelial cancers, according to a systematic review and meta-analysis of observational data.

“Even moderate CKD is associated with elevated risk of kidney cancer and urothelial carcinoma,” Stella K. Kang, MD, of NYU Grossman School of Medicine in New York, New York, and colleagues concluded in a paper published in Nephrology Dialysis Transplantation. “Providers should consider these elevated risks when managing individuals with CKD, particularly when considering evaluation for the presence and etiology of hematuria.”

In an adjusted analysis of 6 mostly good-quality cohort studies including 8,617,563 individuals, patients with CKD had a significant 2.0-fold increased risk of kidney cancer and a 4.0-fold increased risk of urothelial cancer compared with those without CKD, By CKD severity, stage 3 CKD was significantly associated with a 1.9-fold increased risk of kidney cancer and a 1.4-fold increased risk of urothelial carcinoma. Stage 4-5 CKD was significantly associated with a 2.3-fold increased risk of kidney cancer and a 1.2-fold increased risk of urothelial carcinoma.

The incidence rate ratio for kidney cancer was 3.1- and 3.3-fold at CKD stage 3 and 4-5, respectively. The incidence rate ratio for urothelial cancer was 4.4- and 3.1-fold at CKD stage 3 and 4-5, respectively.

The investigators suggested that oxidative stress and inflammation may link CKD to urinary tract cancers. They attempted to control for reverse causation by excluding new CKD in patients with prior cancer diagnosis.

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“While microhematuria is common in CKD, the elevated risk of urinary tract malignancies in moderate and severe CKD warrant complete evaluation, and potentially surveillance, for neoplastic etiology,” Dr Kang’s team wrote.