Comparison of cancer prevalence between patients with glomerulonephritis and the general population at the time of kidney biopsy


Autoři: Jiwon Ryu aff001;  HyunJin Ryu aff002;  Sejoong Kim aff003;  Ho Jun Chin aff003;  Ki Young Na aff003;  Dong-Wan Chae aff003;  Hyung-Jin Yoon aff005
Působiště autorů: Department of Internal Medicine, Cheju Halla General Hospital, Cheju, Republic of Korea aff001;  Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea aff002;  Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea aff003;  Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea aff004;  Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Republic of Korea aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224024

Souhrn

Glomerulonephritis (GN) has been associated with many solid and hematologic malignancies. However, cancer prevalence at the time of GN diagnosis has been rarely examined. We aimed to evaluate the cancer prevalence in patients with GN at the time of kidney biopsy and to compare the results to those of the general population. A total of 1,155 patients who underwent kidney biopsy between 2003 and 2017 were included. We investigated patients diagnosed with cancer within one month of kidney biopsy. The occurrence of cancer was compared with that of the Korean general population using the observed-to-expected rates (O/E ratio). Twenty-nine patients with GN had cancer. The mean age of patients with and without cancer was 49 and 66 years old, respectively. The proportion of male patients with and without cancer was 49.4% and 58.6%, respectively. The glomerular filtration rate was different between the groups (78.1 ± 37.0, 58.0 ± 43.6 ml/min/1.73 m2, p = 0.006), but the urine protein/creatinine ratio was not (3.21 ± 4.01, 5.38 ± 7.47 g/gCr, p = 0.172). Immunoglobulin A nephropathy (IgAN) was the most common GN (37.9%), followed by membranous GN (13.5%), focal segmental glomerulosclerosis (9.7%), minimal change disease (9.2%), amyloidosis (1.2%). Amyloidosis was the most common GN associated with malignancy (20.7%). In patients with amyloidosis, cancer was observed almost 28 times more than expected and these patients showed higher cancer occurrence than patients with other GN (Relative Risk [RR]: 15.73; 95% confidence interval [CI]: 4.82–51.30; p < 0.01). Cancer occurrence was three times greater in GN patients aged > 50 years compared to the general population (O/E ratio: 3.42; 95% CI: 1.37–5.46; p = 0.027). Patients with GN, especially amyloidosis, have higher risk of cancer than the general population at the time of GN diagnosis. Older age (> 50 years) was one of the major determinants of the presence of cancer in GN patients.

Klíčová slova:

Biopsy – Cancer detection and diagnosis – Kidneys – Lupus nephritis – Nephritis – Amyloidosis – Glomerulonephritis – Tin


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