An Increase in Albuminuria is Associated with a Higher Incidence of Malignancies

Overview

Journal Clin Kidney J

Publisher Oxford University Press

Specialty Nephrology

Date 2024 Mar 8

PMID 38455523

Authors

Li Luo

Lyanne M Kieneker

Yuanhang Yang

Roemer J Janse

Alessandro Bosi

Rudolf A de Boer

Priya Vart

Juan-Jesus Carrero

Ron T Gansevoort

Affiliations

Soon will be listed here.

Abstract

Background: A single albuminuria measurement is reported to be an independent predictor of cancer risk. Whether change in albuminuria is also independently associated with cancer is not known.

Methods: We included 64 303 subjects of the Stockholm CREAtinine Measurements (SCREAM) project without a history of cancer and with at least two urine albumin-creatinine ratio (ACR) tests up to 2 years apart. Albuminuria changes were quantified by the fold-change in ACR over 2 years, and stratified into the absence of clinically elevated albuminuria (i.e. never), albuminuria that remained constant, and albuminuria that increased or decreased. The primary outcome was overall cancer incidence. Secondary outcomes were site-specific cancer incidences.

Results: During a median follow-up of 3.7 (interquartile range 3.6-3.7) years, 5126 subjects developed cancer. After multivariable adjustment including baseline estimated glomerular filtration rate and baseline ACR, subjects with increasing ACR over 2 years had a 19% (hazard ratio 1.19; 95% confidence interval 1.08-1.31) higher risk of overall cancer compared with those who never had clinically elevated ACR. No association with cancer risk was seen in the groups with decreasing or constant ACR. Regarding site-specific cancer risks, subjects with increasing ACR or constant ACR had a higher risk of developing urinary tract and lung cancer. No other associations between 2-year ACR changes and site-specific cancers were found.

Conclusions: Increases in albuminuria over a 2-year period are associated with a higher risk of developing overall, urinary tract and lung cancer, independent of baseline kidney function and albuminuria. These data add important weight to the link that exists between albuminuria and cancer incidence.

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