The 'other' big complication: how chronic kidney disease impacts on cancer risks and outcomes.

Lees, Jennifer S ORCID: 0000-0001-6331-0178, Elyan, Benjamin MP ORCID: 0000-0001-8848-1395, Herrmann, Sandra M, Lang, Ninian N ORCID: 0000-0001-8441-6887, Jones, Robert J ORCID: 0000-0001-5608-001X and Mark, Patrick B ORCID: 0000-0003-3387-2123 (2023) The 'other' big complication: how chronic kidney disease impacts on cancer risks and outcomes. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 38 (5). pp. 1071-1079.

Access the full-text of this item by clicking on the Open Access link.

Abstract

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.

Item Type:	Article
Uncontrolled Keywords:	Kidney, Humans, Neoplasms, Cardiovascular Diseases, Creatinine, Glomerular Filtration Rate, Risk, Renal Insufficiency, Chronic
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	06 Feb 2024 11:12
Last Modified:	06 Feb 2024 11:12
DOI:	10.1093/ndt/gfac011
Open Access URL:	https://doi.org/10.1093/ndt/gfac011
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3178480