The 'other' big complication: how chronic kidney disease impacts on cancer risks and outcomes.
The 'other' big complication: how chronic kidney disease impacts on cancer risks and outcomes.
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“另一个”大并发症：慢性肾病如何影响癌症风险和结果。
DOI：
10.1093/ndt/gfac011
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发表时间：
2023-05-04
期刊：
影响因子：
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癌症是慢性肾脏病（CKD）患者死亡的第二大原因，仅次于心血管疾病。CKD在癌症患者中的发病率高于非癌症人群。在不同人群中，与无CKD的人群相比，CKD与癌症发病率和癌症死亡风险升高相关，尽管风险是癌症部位特异性的。在轻度CKD [估计肾小球滤过率（eGFR）60-89 mL/min/1.73 m2]中可检测到更高的癌症风险，尽管如果使用肾脏疾病的敏感标志物，如胱抑素C，这种风险会更明显。与eGFR无关，白蛋白尿与部位特异性癌症发病率和死亡风险增加相关。在这里，我们探讨了在CKD中观察到的癌症风险增加的潜在机制，包括患者因素（共同风险，如心脏代谢疾病，肥胖，吸烟，饮食，生活方式和环境），疾病（遗传，炎症和感染）和治疗因素。特别是，我们讨论了与常规化疗和较新的全身抗癌治疗（包括靶向和免疫治疗）相关的肾脏不良事件可能导致CKD患者癌症结局恶化的方式。最后，我们回顾了在用于CKD管理的风险预测工具中承认癌症风险增加的潜在益处。
Cancer is the second leading cause of death in people with chronic kidney disease (CKD) after cardiovascular disease. The incidence of CKD in patients with cancer is higher than in the non-cancer population. Across various populations, CKD is associated with an elevated risk of cancer incidence and cancer death compared with people without CKD, although the risks are cancer site-specific. Higher risk of cancer is detectable in mild CKD [estimated glomerular filtration rate (eGFR) 60–89 mL/min/1.73 m2], although this risk is more obvious if sensitive markers of kidney disease are used, such as cystatin C. Independent of eGFR, albuminuria is associated with increased risk of site-specific cancer incidence and death. Here, we explore the potential mechanisms for the increased risk of cancer observed in CKD, including patient factors (shared risks such as cardiometabolic disease, obesity, smoking, diet, lifestyle and environment), disease (genetic, inflammatory and infective) and treatment factors. In particular, we discuss the ways in which renal adverse events associated with conventional chemotherapies and newer systemic anti-cancer therapies (including targeted and immunotherapies) may contribute to worse cancer outcomes in people with CKD. Finally, we review the potential benefits of acknowledging increased risk of cancer in risk prediction tools used for the management of CKD.
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DOI：
10.1056/nejmoa1003466
发表时间：
2010-08-19
期刊：
The New England journal of medicine
影响因子：
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作者：
Hodi FS;O'Day SJ;McDermott DF;Weber RW;Sosman JA;Haanen JB;Gonzalez R;Robert C;Schadendorf D;Hassel JC;Akerley W;van den Eertwegh AJ;Lutzky J;Lorigan P;Vaubel JM;Linette GP;Hogg D;Ottensmeier CH;Lebbé C;Peschel C;Quirt I;Clark JI;Wolchok JD;Weber JS;Tian J;Yellin MJ;Nichol GM;Hoos A;Urba WJ
通讯作者：
Urba WJ
DOI：
10.1056/nejmoa1409405
发表时间：
2014-12-25
期刊：
The New England journal of medicine
影响因子：
--
作者：
Genovese G;Kähler AK;Handsaker RE;Lindberg J;Rose SA;Bakhoum SF;Chambert K;Mick E;Neale BM;Fromer M;Purcell SM;Svantesson O;Landén M;Höglund M;Lehmann S;Gabriel SB;Moran JL;Lander ES;Sullivan PF;Sklar P;Grönberg H;Hultman CM;McCarroll SA
通讯作者：
McCarroll SA
DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
影响因子：
3.3
作者：
Ishii, Taisuke;Fujimaru, Takuya;Komatsu, Yasuhiro
通讯作者：
Komatsu, Yasuhiro
影响因子：
11.4
作者：
Dawoud AAZ;Gilbert RD;Tapper WJ;Cross NCP
通讯作者：
Cross NCP