Kidney function and cancer risk: An analysis using creatinine and cystatin C in a cohort study.
Kidney function and cancer risk: An analysis using creatinine and cystatin C in a cohort study.
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DOI：
10.1016/j.eclinm.2021.101030
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发表时间：
2021-08
影响因子：
15.1
通讯作者：
Mark PB
中科院分区：
文献类型：
--
作者：
Lees JS;Ho F;Parra-Soto S;Celis-Morales C;Welsh P;Sullivan MK;Jani BD;Sattar N;Lang NN;Pell JP;Webster AC;Mark PB
我们研究了癌症发病率和死亡风险的增加是否与肾功能和白蛋白尿有关，以及当使用半胱氨酸蛋白酶抑制剂C估计肾功能时，是否更容易识别这种风险。参与者来自英国生物银行（招募时间跨度为2007-2010年），不包括先前诊断为癌症的患者。使用肌酐（eGFRcr）、半胱氨酸蛋白酶抑制剂C（eGFRcys）和肌酐-半胱氨酸蛋白酶抑制剂C（eGFRcr-cys）计算估计的肾小球滤过率（ml/min/1.73m2）。考克斯比例风险模型检验了eGFR、尿白蛋白：肌酐比值（uACR）与癌症发病率和死亡率之间的相关性。在431，263名参与者中，中位随访时间为11.3（IQR 10.6-12.0）年，有41，745例癌症事件和11，764例癌症死亡。eGFRcys与癌症发病率和死亡的相关性最强（HR分别为1.04（95% CI 1.03-1.04）和1.06（1.05-1.07）/10 ml/min/1.73 m2下降）。eGFRcr与任一结局均无关（发生率：HR 1.00（1.00-1.01）;死亡：HR 0.99（0.98-1.01）/10 ml/min/1.73 m2下降）。相对于eGFRcys>90或uACR<3 mg/mmol，eGFRcys 60 -89（HR 1.04（95% CI 1.02-1.07））、eGFRcys<60（HR 1.19（1.14-1.24））和uACR≥3 mg/mmol（HR 1.09（1.06-1.12））与较高的癌症发病风险相关。eGFRcys 60 -89（HR 1.15（1.10-1.21））; eGFRcys<60（HR 1.48（1.38-1.59））和uACR≥3 mg/mmol（HR 1.17（1.11-1.24））与癌症死亡相关。在早期慢性肾病中，eGFRcys比目前的措施更容易捕获癌症发病率和癌症死亡的过度风险。肾功能、uACR和癌症死亡之间的关联尤其令人担忧，值得进一步审查。首席科学家办公室;智利ANID Becas;医学研究理事会;英国医学协会;英国心脏基金会。
We examined whether an increased risk of cancer incidence and death is associated with kidney function and albuminuria and whether the risk is more readily identified when kidney function is estimated using cystatin C. Participants were from UK Biobank (recruitment spanning 2007–2010), excluding those with a prior diagnosis of cancer. Estimated glomerular filtration rate (ml/min/1.73m2) was calculated using creatinine (eGFRcr), cystatin C (eGFRcys) and creatinine-cystatin C (eGFRcr-cys). Cox proportional hazards models tested associations between eGFR, urinary albumin:creatinine ratio (uACR) and cancer incidence and death. In 431,263 participants over median follow-up of 11.3 (IQR 10.6–12.0) years, there were 41,745 incident cancers and 11,764 cancer deaths. eGFRcys was most strongly associated with cancer incidence and death (HR 1.04 (95% CI 1.03–1.04) and 1.06 (1.05–1.07) per 10 ml/min/1.73m2 decline, respectively). eGFRcr was not associated with either outcome (incidence: HR 1.00 (1.00–1.01); death: HR 0.99 (0.98–1.01) per 10 ml/min/1.73m2 decline). Relative to eGFRcys>90 or uACR<3 mg/mmol, eGFRcys60–89 (HR 1.04 (95% CI 1.02–1.07)), eGFRcys<60 (HR 1.19 (1.14–1.24)) and uACR≥3 mg/mmol (HR 1.09 (1.06–1.12)) were associated with higher risk of incident cancer. eGFRcys60–89 (HR 1.15 (1.10–1.21)); eGFRcys<60 (HR 1.48 (1.38–1.59)) and uACR≥3 mg/mmol (HR 1.17 (1.11–1.24)) were associated with cancer death. Excess risk of cancer incidence and cancer death is more readily captured in early chronic kidney disease by eGFRcys than by current measures. The association between kidney function, uACR and cancer death in particular is concerning and warrants further scrutiny. Chief Scientist Office; ANID Becas Chile; Medical Research Council; British Medical Association; British Heart Foundation.
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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
作者：
Park, Sehoon;Lee, Soojin;Kim, Dong Ki
通讯作者：
Kim, Dong Ki
影响因子：
3.3
作者：
Ishii, Taisuke;Fujimaru, Takuya;Komatsu, Yasuhiro
通讯作者：
Komatsu, Yasuhiro
影响因子：
17.1
作者：
Peired, Anna Julie;Antonelli, Giulia;Romagnani, Paola
通讯作者：
Romagnani, Paola
影响因子：
5
作者：
Mok, Yejin;Ballew, Shoshana H.;Matsushita, Kunihiro
通讯作者：
Matsushita, Kunihiro