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. 2023 Feb 17;18(1):20220553.
doi: 10.1515/biol-2022-0553. eCollection 2023.

Meta-analysis of cancer risk among end stage renal disease undergoing maintenance dialysis

Xin Xie  1   2   3 , Fang Li  4 , Longsheng Xie  1   2   3 , Yanxia Yu  1   2   3 , Santao Ou  2   3 , Rongfang He  1   5   3
Affiliations

Meta-analysis of cancer risk among end stage renal disease undergoing maintenance dialysis

Xin Xie et al. Open Life Sci. .

Abstract

Currently, there is no consensus on whether maintenance dialysis increases cancer risk in patients with end-stage renal disease (ESRD). Therefore, this study was to systematically evaluate the risk of cancer among ESRD patients undergoing maintenance dialysis. Related studies on the impact of maintenance dialysis on cancer risk were retrieved from PubMed, Embase, Cochrane Library, and other databases from their respective inceptions to 19 February 2021. ESRD patients receiving maintenance dialysis were classified into cancer including non-melanoma skin cancer (NMSC) and cancer excluding NMSC. Standardized incidence ratio (SIR) with its 95% confidence interval (95% CI) was calculated to assess cancer risk. Fourteen studies were included in the meta-analysis. The risk of cancer in patients undergoing maintenance dialysis (with or without NMSC) was significantly higher than controls both in cancer including NMSC (SIR = 1.38, 95% CI: 1.27-1.49, P < 0.001) and cancer excluding NMSC (SIR = 1.34, 95% CI: 1.23-1.47, P < 0.001). Subgroup results identified the higher risk of cancer incidence in both men and women receiving maintenance dialysis. Meanwhile, elevated excess risks were observed among patients with younger age and shorter follow-up time (P < 0.001). Meanwhile, the combined SIR of bladder, cervix, colorectum, kidney, liver, thyroid, tongue, and other cancers were all increased (P < 0.05). ESRD patients undergoing dialysis has higher risk of cancer.

Keywords: cancer incidence; maintenance dialysis; meta-analysis.

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Conflict of interest statement

Conflict of interest: Authors state no conflict of interest.

Figures

Figure 1
Figure 1
The detailed flow chart of study selection.
Figure 2
Figure 2
Forest plot for meta-analyzing the risk of cancer among maintenance hemodialysis patients.
Figure 3
Figure 3
Sensitivity analysis of meta-analyzing the cancer risk among patients with cancer including NMSC and patients with cancer excluding NMSC. (a) Cancer including NMSC and (b) cancer excluding NMSC.
See this image and copyright information in PMC

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