Abstract: SA-PO238
Albuminuria Changes and Risk of Incident Cancer: The Stockholm CREAtinine Measurements (SCREAM) Project
Session Information
- Onconephrology: Immunological Cross-Talk
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Luo, Li, Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Kieneker, Lyanne M., Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Janse, Roemer J., Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Bosi, Alessandro, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- de Boer, Rudolf A., Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
- Vart, Priya, Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Gansevoort, Ron T., Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Carrero, Juan Jesus, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
Background
A single albuminuria measurement is reported to be an independent predictor of future cancer risk. Whether progressive albuminuria (i.e. albuminuria changes) adds further prognostication 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 2 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; 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 (IQR, 3.6-3.7) years, 5,126 subjects developed de novo cancer. After multivariable adjustment including baseline estimated glomerular filtration rate and baseline ACR, subjects with increasing ACR over 2 years had a 19% (HR, 1.19; 95% CI, 1.08-1.31) higher risk of overall cancer compared to those with absent albuminuria. 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.
Conclusion
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.
Figure 1. Distribution of 2-year ACR changes (panel A) and adjusted hazard ratio of overall cancer incidence associated with 2-year ACR changes (panel B). Restricted cubic splines of 2-year ACR changes with 3 knots at 0.1, 0.5, 0.9 quantiles of 2-year ACR fold change.