Kidney Function and Risk of Renal Cell Carcinoma
Menée à partir de données 2006-2010 de la "UK Biobank" portant sur 463 178 personnes (durée médiane de suivi : 12,6 ans), cette étude analyse l'association entre le débit de filtration glomérulaire et le risque de carcinome à cellules rénales (1 447 cas)
We evaluated the temporal association between kidney function, assessed by estimated glomerular filtration rate (eGFR), and the risk of incident renal cell carcinoma (RCC). We also evaluated whether eGFR could improve RCC risk discrimination beyond established risk factors.We analyzed the UK Biobank cohort, including 463,178 participants of whom 1,447 were diagnosed with RCC during 5,696,963 person-years of follow-up. We evaluated the temporal association between eGFR and RCC risk using flexible parametric survival models, adjusted for C-reactive protein and RCC risk factors. eGFR was calculated from creatinine and cystatin C levels.Lower eGFR, an indication of poor kidney function, was associated with higher RCC risk when measured up to 5 years prior to diagnosis. The RCC HR per SD decrease in eGFR when measured 1 year before diagnosis was 1.26 [95% confidence interval (95% CI), 1.16–1.37], and 1.11 (95% CI, 1.05–1.17) when measured 5 years before diagnosis. Adding eGFR to the RCC risk model provided a small improvement in risk discrimination 1 year before diagnosis with an AUC of 0.73 (95% CI, 0.67–0.84) compared with the published model (0.69; 95% CI, 0.63–0.79).This study demonstrated that kidney function markers are associated with RCC risk, but the nature of these associations are consistent with reversed causality. Markers of kidney function provided limited improvements in RCC risk discrimination beyond established risk factors.eGFR may be of potential use to identify individuals in the extremes of the risk distribution.