Albuminuria, Kidney Function, and Cancer Risk in the Community
Menée aux Etats-Unis à partir de données portant sur 8 935 personnes (âge moyen : 63 ans ; durée médiane de suivi : 14,7 ans ; 56 % de femmes), cette étude analyse l'association entre le débit de filtration glomérulaire du rein ou le rapport albumine/créatinine dans les urines et le risque de cancer, par localisation (2 030 cas)
Few studies comprehensively investigated the association of two key kidney measures, estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR), with cancer incidence. In 8,935 participants at the baseline (1996-98) from the Atherosclerosis Risk in Communities (ARIC) study, we quantified the associations of eGFR (based on creatinine and cystatin C) and ACR with cancer risk using Cox regression models adjusted for potential confounders. Due to changing guidelines for prostate cancer screening during the follow-up, we investigated overall cancer, overall non-prostate cancer, and site-specific cancer. During a median follow-up of 14.7 years, 2,030 incident cancer cases occurred. In demographically-adjusted model, low eGFR and high ACR were associated with cancer incidence (both overall and overall non-prostate cancer). These associations were attenuated after adjusting for other shared risk factors, with a significant association remaining only for ACR (≥103 compared to 5 mg/g) and overall non-prostate cancer. For site-specific cancer, only high ACR showed a significant association with lung and urinary tract cancers. Of these, the association between ACR and lung cancer appeared most robust in several sensitivity analyses. Kidney measures, particularly high ACR, were independently associated with cancer risk. The association between ACR and lung cancer was uniquely robust, warranting future studies to explore potential mechanisms.