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Dialysis-requiring acute kidney injury increases risk of long-term malignancy: a population-based study

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Abstract

Background

Acute kidney injury (AKI) is gaining worldwide attention recently, emerging as a major public health threat. However, the association between the development of AKI and subsequent malignancy has not been studied before.

Methods

We conducted a population study based on the Taiwan National Health Insurance database, using 1,000,000 representative database during 2000–2008. All patients’ survival to discharge from index hospitalization with recovery from dialysis-requiring AKI were identified (recovery group), and matched with those without recovery and those without AKI, at a 1:1:1 ratio.

Results

We identified 625 individuals more than 18 years old [352 male (56.5 %); mean age, 63.3 years] in recovery group and matched 625 individuals in each group. During a mean followed-up of 3.7 years, the incidences of new-onset malignancy were 4.2, 2.9, and 2.6 per 100 person-year among the non-recovery, the recovery, and the non-AKI group, respectively. After adjustment, the recovery group was more likely to develop long-term de novo malignancy than those without AKI [hazard ratio (HR) 1.44, 95 % confidence interval (CI) 1.02–2.03; p = 0.04], while less likely than those who did not recover (HR 0.66, 95 % CI 0.45–0.98; p = 0.04).

Conclusions

Dialysis-requiring AKI can post a long-term risk of de novo malignancy for those who survive from the initial insult. Even patients who have recovered from dialysis still carry a significantly higher possibility of developing malignancy than those without AKI episode.

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Acknowledgments

The authors thank Ms. Hui-Yu Huang for her statistical support. This study was supported by Taiwan National Science Council (Grant NSC 101-2314-B-002-132-MY3, Grant NSC 101-2314-B-002-085-MY3, and Grant NSC 100-2314-B-002-119-), 100-N1776 from NTUH, 101-M1953, 102-S2097.

Conflict of interest

The authors report no conflicts of interest.

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Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei, 100, Taiwan

    Chia-Ter Chao, Chun-Fu Lai, Tze-Wah Kao, Tzong-Shinn Chu, Chia-Hsui Chang, Vin-Cent Wu & Kwan-Dun Wu

  2. Department of Internal Medicine, and Medical Research Center, Cardinal Tien Hospital, Fu Jen Catholic University, New Taipei City, Taiwan

    Cheng-Yi Wang

  3. Division of Nephrology, Department of Internal Medicine, Yun-Lin Branch, National Taiwan University Hospital, Taipei, Taiwan

    Tao-Min Huang

  4. Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan

    Yen-Yuan Chen

  5. Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan

    Wen-Je Ko

  6. Institute of Population Health Sciences, National Health Research Institutes, No. 35, Keyan Road, Zhunan, 350, Taiwan

    Likwang Chen

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  1. Chia-Ter Chao
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The National Taiwan University Study Group on Acute Renal Failure (NSARF)

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Correspondence to Vin-Cent Wu.

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Chao, CT., Wang, CY., Lai, CF. et al. Dialysis-requiring acute kidney injury increases risk of long-term malignancy: a population-based study. J Cancer Res Clin Oncol 140, 613–621 (2014). https://doi.org/10.1007/s00432-014-1600-z

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  • DOI: https://doi.org/10.1007/s00432-014-1600-z

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