Cancer Incidence Higher in Patients with CKD

Boston—In the United States, cancer is a leading cause of morbidity and mortality. Further, an estimated one in three Americans is at risk for chronic kidney disease (CKD). There are data from previous studies on the risk of certain cancers in patients on dialysis; however, studies on the incidence of cancer in patients with CKD are limited. Jagadeesh Puvvula, PharmD, MPH, and colleagues conducted an analysis of patients > 18 years of age from the University of Nebraska Medical Center (UNMC, Omaha) clinical data warehouse. The researchers reported results of the analysis during a poster session at the NKF Spring Clinical Meetings in a poster titled Incidence of Cancer in Chronic Kidney Disease. Eligible patients had a clinical diagnosis of CKD and received care at UNMC from 2008 to 2018. The clinical data warehouse is based on monthly data extracts from the enterprise electronic health record, de-identified and managed using international data standards. The researchers calculated the crude and age-adjusted incidence rate of cancer based on patients with CKD who were eventually diagnosed with a primary malignancy. To calculate the age-adjusted incidence for the United States and the Nebraska Omaha-Council Bluffs region for a comparison with the incidence among patients with CKD at UNMC, population estimates for the Omaha region were extracted from the US Census Bureau 2010 Decennial Census data and the CKD Wonder Database. During the study period, there were 20,400 patients with CKD. Of those, 813 developed an invasive malignancy. The most common diagnosed malignancies were digestive system (n=129), urinary tract (n=105), respiratory tract (n=96), melanoma  and other invasive skin cancers (n=95), and hematologic malignancies (n=90). The incidence of cancer among patients with CKD was much higher than in the general population in Nebraska: 3220 per 100,000 population versus 645 per 100,000 population, respectively. The cancers with the highest incidence as compared with the general population were hematologic malignancies (412.6 per 100,000 population vs 18.7 per 100,000 population, respectively), skin cancer (412.7 per 100,000 population vs 30.6 per 100,000 population, respectively), and urinary system (454.8 per 100,000 population vs 54.3 per 100,000 population, respectively). “CKD patients have a significantly increased incidence of cancer,” the researchers said in conclusion. Source: Puvvula J, Campbell WS, Ganti AK, Tendulkar K. Incidence of cancer in chronic kidney disease. Abstract of a poster presented at the National Kidney Foundation 2019 Spring Clinical Meetings, May 8-12, 2019, Boston, Massachusetts.