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01-03-2023 | Kidney Cancer | Nephrology - Original Paper

Comparison of the risks of renal cell carcinoma or urothelial cancer between hemodialysis and peritoneal dialysis patients

Authors: I-Kuan Wang, Tung-Min Yu, Tzung-Hai Yen, Cheng-Li Lin, Chi-Yuan Li, Chieh-Min Hsu, Tsung-Hsun Tsai, Fung-Chang Sung

Published in: International Urology and Nephrology | Issue 9/2023

Abstract

Purpose

This study is to compare risks of developing renal cell carcinoma or urothelial cancer between hemodialysis (HD) and peritoneal dialysis (PD) patients.

Methods

The age-, sex-, and index year-matched patients with newly diagnosed end-stage kidney disease (ESKD) undergoing dialysis [HD (N = 22,587) or PD (N = 11,547)] from 2000 to 2015 in Taiwan were identified.

Patients were followed until the development of renal cell carcinoma or urothelial cancer, renal transplantation, death, or the end of follow-up (December 31, 2017). The hazard ratio (HR), and sub-hazards ratio (SHR), in which death was considered as a competing risk, of developing renal cell carcinoma or urothelial cancer were compared between the HD and PD patients.

Results

The incidence rate of renal cell carcinoma was higher in the PD group than in age-, sex-, and index year-matched HD group (11.5 versus 5.52 per 10,000 person-years), with an adjusted HR of 2.15 (95% confidence interval (CI) = 1.59, 2.92), and an adjusted SHR of 1.97 (95% CI = 1.46, 2.67). The incidence rate of urothelial cancer was also higher in the PD group than in corresponding HD group (40.3 and 34.0 per 10,000 person-years), with an adjusted HR of 1.15 (95% CI = 1.00, 1.33) and an adjusted SHR of 1.08 (95% CI = 0.94, 1.25). These findings were further validated in propensity score-matched dialysis cohorts.

Conclusions

ESKD patients undergoing PD are at a higher risk of developing renal cell carcinoma than those on HD, but risks of developing urothelial cancer are similar among the two groups.

Collins AJ, Foley RN, Herzog C, Chavers BM, Gilbertson D, Ishani A, Kasiske BL, Liu J, Mau LW, McBean M, Murray A, St Peter W, Guo H, Li Q, Li S, Li S, Peng Y, Qiu Y, Roberts T, Skeans M, Snyder J, Solid C, Wang C, Weinhandl E, Zaun D, Arko C, Chen SC, Dalleska F, Daniels F, Dunning S, Ebben J, Frazier E, Hanzlik C, Johnson R, Sheets D, Wang X, Forrest B, Constantini E, Everson S, Eggers PW, Agodoa L (2010) Excerpts from the US renal data system 2009 annual data report. Am J Kidney Dis 55:1–420. https://doi.org/10.1053/j.ajkd.2009.10.009CrossRef

Butler AM, Olshan AF, Kshirsagar AV, Edwards JK, Nielsen ME, Wheeler SB, Brookhart MA (2015) Cancer incidence among US Medicare ESRD patients receiving hemodialysis, 1996–2009. Am J Kidney Dis 65(5):763–772. https://doi.org/10.1053/j.ajkd.2014.12.013CrossRefPubMedPubMedCentral

Maisonneuve P, Agodoa L, Gellert R, Stewart JH, Buccianti G, Lowenfels AB, Wolfe RA, Jones E, Disney AP, Briggs D, McCredie M, Boyle P (1999) Cancer in patients on dialysis for end-stage renal disease: an international collaborative study. Lancet 354(9173):93–99. https://doi.org/10.1016/s0140-6736(99)06154-1CrossRefPubMed

Au EH, Chapman JR, Craig JC, Lim WH, Teixeira-Pinto A, Ullah S, McDonald S, Wong G (2019) Overall and Site-Specific Cancer Mortality in Patients on Dialysis and after Kidney Transplant. J Am Soc Nephrol. https://doi.org/10.1681/ASN.2018090906CrossRefPubMedPubMedCentral

Akizawa T, Kinugasa E, Koshikawa S (1994) Increased risk of malignancy and blood-membrane interactions in uraemic patients. Nephrol Dial Transplant 9(2):162–164PubMed

Foshat M, Eyzaguirre E (2017) Acquired Cystic Disease-Associated Renal Cell Carcinoma: Review of Pathogenesis, Morphology, Ancillary Tests, and Clinical Features. Arch Pathol Lab Med 141(4):600–606. https://doi.org/10.5858/arpa.2016-0123-RSCrossRefPubMed

Vamvakas S, Bahner U, Heidland A (1998) Cancer in end-stage renal disease: potential factors involved -editorial. Am J Nephrol 18(2):89–95. https://doi.org/10.1159/000013314CrossRefPubMed

Guillou PJ, Woodhouse LF, Davison AM, Giles GR (1980) Suppressor cell activity of peripheral mononuclear cells from patients undergoing chronic haemodialysis. Biomedicine 32(1):11–17PubMed

Pan HC, Sun CY, Wu IW, Tsai TL, Sun CC, Lee CC (2019) Higher risk of malignant neoplasms in young adults with end-stage renal disease receiving haemodialysis: A nationwide population-based study. Nephrology (Carlton) 24(11):1165–1171. https://doi.org/10.1111/nep.13555CrossRefPubMed

10.

Fortuny J, Kogevinas M, Zens MS, Schned A, Andrew AS, Heaney J, Kelsey KT, Karagas MR (2007) Analgesic and anti-inflammatory drug use and risk of bladder cancer: a population based case control study. BMC Urol 7:13. https://doi.org/10.1186/1471-2490-7-13CrossRefPubMedPubMedCentral

11.

Wang SM, Lai MN, Wei A, Chen YY, Pu YS, Chen PC, Wang JD (2014) Increased risk of urinary tract cancer in ESRD patients associated with usage of Chinese herbal products suspected of containing aristolochic acid. PLoS ONE 9(8):105218. https://doi.org/10.1371/journal.pone.0105218CrossRef

12.

Wang IK, Cheng YK, Lin CL, Peng CL, Chou CY, Chang CT, Yen TH, Huang CC, Sung FC, Hsu CY (2015) Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD. Clin J Am Soc Nephrol 10(6):994–1001. https://doi.org/10.2215/CJN.08140814CrossRefPubMedPubMedCentral

13.

Wang IK, Kung PT, Kuo WY, Tsai WC, Chang YC, Liang CC, Chang CT, Yeh HC, Wang SM, Chuang FR, Wang KY, Lin CY, Huang CC (2013) Impact of dialysis modality on the survival of end-stage renal disease patients with or without cardiovascular disease. J Nephrol 26(2):331–341. https://doi.org/10.5301/jn.5000149CrossRefPubMed

14.

Wang IK, Liang WM, Lin CL, Liu YL, Chang CT, Yen TH, Huang CC, Sung FC (2016) Impact of dialysis modality on the survival of patients with end-stage renal disease and prior stroke. Int Urol Nephrol 48(1):139–147. https://doi.org/10.1007/s11255-015-1157-zCrossRefPubMed

15.

Weinhandl ED, Foley RN, Gilbertson DT, Arneson TJ, Snyder JJ, Collins AJ (2010) Propensity-matched mortality comparison of incident hemodialysis and peritoneal dialysis patients. J Am Soc Nephrol 21(3):499–506. https://doi.org/10.1681/ASN.2009060635CrossRefPubMedPubMedCentral

16.

Lee YC, Hung SY, Wang HK, Lin CW, Wang HH, Chang MY, Sung JM, Chiou YY, Lin SH (2018) Is there different risk of cancer among end-stage renal disease patients undergoing hemodialysis and peritoneal dialysis? Cancer Med 7(2):485–498. https://doi.org/10.1002/cam4.1289CrossRefPubMedPubMedCentral

17.

Stewart JH, Buccianti G, Agodoa L, Gellert R, McCredie MR, Lowenfels AB, Disney AP, Wolfe RA, Boyle P, Maisonneuve P (2003) Cancers of the kidney and urinary tract in patients on dialysis for end-stage renal disease: analysis of data from the United States, Europe, and Australia and New Zealand. J Am Soc Nephrol 14(1):197–207. https://doi.org/10.1097/01.asn.0000039608.81046.81CrossRefPubMed

18.

Kao WH, Hong JH, See LC, Yu HP, Hsu JT, Chou IJ, Chou WC, Chiou MJ, Wang CC, Kuo CF (2018) Validity of cancer diagnosis in the National Health Insurance database compared with the linked National Cancer Registry in Taiwan. Pharmacoepidemiol Drug Saf 27(10):1060–1066. https://doi.org/10.1002/pds.4267CrossRefPubMed

19.

Gooley TA, Leisenring W, Crowley J, Storer BE (1999) Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med 18(6):695–706. https://doi.org/10.1002/(sici)1097-0258(19990330)18:6%3c695::aid-sim60%3e3.0.co;2-oCrossRefPubMed

20.

Wang IK, Lin CL, Chen HC, Lin SY, Chang CT, Yen TH, Sung FC (2018) Risk of new-onset diabetes in end-stage renal disease patients undergoing dialysis: analysis from registry data of Taiwan. Nephrol Dial Transplant 33(4):670–675. https://doi.org/10.1093/ndt/gfx250CrossRefPubMed

21.

Wang IK, Lin CL, Yen TH, Lin SY, Sung FC (2018) Comparison of survival between hemodialysis and peritoneal dialysis patients with end-stage renal disease in the era of icodextrin treatment. Eur J Intern Med 50:69–74. https://doi.org/10.1016/j.ejim.2017.11.017CrossRefPubMed

22.

Wang IK, Chang YC, Liang CC, Chuang FR, Chang CT, Lin HH, Lin CC, Yen TH, Lin PC, Chou CY, Huang CC, Tsai WC, Chen JH (2012) Bacteremia in hemodialysis and peritoneal dialysis patients. Intern Med 51(9):1015–1021. https://doi.org/10.2169/internalmedicine.51.7111CrossRefPubMed

23.

Wang IK, Yu TM, Yen TH, Yip HT, Lai PC, Li CY, Sun KT, Sung FC (2022) The impact of multidisciplinary pre-dialysis care on the outcomes of incident peritoneal dialysis patients. BMC Nephrol 23(1):173. https://doi.org/10.1186/s12882-022-02800-zCrossRefPubMedPubMedCentral

24.

Luo HL, Ohyama C, Hatakeyama S, Wang HJ, Yoneyama T, Yang WC, Chuang YC, Chen YT, Lee WC, Cheng YT, Kang CH, Chiang PH (2020) Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan-Japan UTUC Collaboration Cohort. Int J Urol 27(4):327–332. https://doi.org/10.1111/iju.14188CrossRefPubMed

25.

Chen JS, Lu CL, Huang LC, Shen CH, Chen SC (2016) Chronic kidney disease is associated with upper tract urothelial carcinoma: a nationwide population-based cohort study in Taiwan. Medicine 95(14):3255. https://doi.org/10.1097/MD.0000000000003255CrossRef

26.

Lin MY, Niu SW, Li WM, Lee HL, Chen LT, Wu WJ, Hwang SJ (2022) Incidence and survival variations of upper tract urothelial cancer in Taiwan (2001–2010). Int J Urol 29(2):121–127. https://doi.org/10.1111/iju.14731CrossRefPubMed

27.

Ouzzane A, Roupret M, Leon P, Yates DR, Colin P (2014) Epidemiology and risk factors of upper urinary tract tumors: literature review for the yearly scientific report of the French National Association of Urology. Prog Urol 24(15):966–976. https://doi.org/10.1016/j.purol.2014.06.012CrossRefPubMed

28.

Ou JH, Pan CC, Lin JS, Tzai TS, Yang WH, Chang CC, Cheng HL, Lin YM, Tong YC (2000) Transitional cell carcinoma in dialysis patients. Eur Urol 37(1):90–94. https://doi.org/10.1159/000020106CrossRefPubMed

29.

Teitelbaum I, Burkart J (2003) Peritoneal dialysis. Am J Kidney Dis 42(5):1082–1096. https://doi.org/10.1016/j.ajkd.2003.08.036CrossRefPubMed

30.

Garcia-Lopez E, Lindholm B, Davies S (2012) An update on peritoneal dialysis solutions. Nat Rev Nephrol 8(4):224–233. https://doi.org/10.1038/nrneph.2012.13CrossRefPubMed

31.

Coussens LM, Werb Z (2002) Inflammation and cancer. Nature 420(6917):860–867. https://doi.org/10.1038/nature01322CrossRefPubMedPubMedCentral

32.

Johnson DW, Armstrong K, Campbell SB, Mudge DW, Hawley CM, Coombes JS, Prins JB, Isbel NM (2007) Metabolic syndrome in severe chronic kidney disease: Prevalence, predictors, prognostic significance and effects of risk factor modification. Nephrology (Carlton) 12(4):391–398. https://doi.org/10.1111/j.1440-1797.2007.00804.xCrossRefPubMed

33.

Zhao H, Grossman HB, Spitz MR, Lerner SP, Zhang K, Wu X (2003) Plasma levels of insulin-like growth factor-1 and binding protein-3, and their association with bladder cancer risk. J Urol 169(2):714–717. https://doi.org/10.1097/01.ju.0000036380.10325.2aCrossRefPubMed

Title: Comparison of the risks of renal cell carcinoma or urothelial cancer between hemodialysis and peritoneal dialysis patients
Authors: I-Kuan Wang
Tung-Min Yu
Tzung-Hai Yen
Cheng-Li Lin
Chi-Yuan Li
Chieh-Min Hsu
Tsung-Hsun Tsai
Fung-Chang Sung
Publication date: 01-03-2023
Publisher: Springer Netherlands
Keywords: Kidney Cancer
Kidney Cancer
Peritoneal Dialysis
Kidney Cancer
Urothelial Cancer
Urothelial Cancer
Published in: International Urology and Nephrology / Issue 9/2023
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-023-03534-z

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