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Meta-Analysis
. 2025 Nov;133(10):1535-1543.
doi: 10.1038/s41416-025-03140-z. Epub 2025 Sep 6.

Chronic kidney disease and incident cancer risk: an individual participant data meta-analysis

Yejin Mok  1 , Aditya Surapaneni  2 , Yingying Sang  3 , Josef Coresh  3 , Morgan E Grams  2 , Kunihiro Matsushita  1 , Shoshana H Ballew  4 , Natalia Alencar de Pinho  5 , Johan Ärnlöv  6   7 , Sandhi M Barreto  8 , Samira Bell  9 , Hermann Brenner  10 , Juan-Jesus Carrero  11   12 , Rajkumar Chinnadurai  13 , Elizabeth Ciemins  14 , Ron T Gansevoort  15 , Simerjot K Jassal  16   17 , Keum Ji Jung  18 , H Lester Kirchner  19 , Tsuneo Konta  20 , Csaba P Kovesdy  21 , Li Luo  15 , Krutika Pandit  2 , Mahboob Rahman  22 , Cassianne Robinson-Cohen  23 , Charumathi Sabanayagam  24   25 , Ulla T Schultheiss  26   27   28 , Michael Shlipak  29   30 , Natalie Staplin  31 , Marcello Tonelli  32 , Angela Yee-Moon Wang  33 , Chi-Pang Wen  34 , Mark Woodward  35   36 , Jennifer S Lees  37   38 ; CKD Prognosis Consortium
Collaborators, Affiliations
Meta-Analysis

Chronic kidney disease and incident cancer risk: an individual participant data meta-analysis

Yejin Mok et al. Br J Cancer. 2025 Nov.

Abstract

Background: Studies examining the association of chronic kidney disease (CKD) with cancer risk have demonstrated conflicting results.

Methods: This was an individual participant data meta-analysis including 54 international cohorts contributing to the CKD Prognosis Consortium. Included cohorts had data on albuminuria [urine albumin-to-creatinine ratio (ACR)], estimated glomerular filtration rate (eGFR), overall and site-specific cancer incidence, and established risk factors for cancer. Included participants were aged 18 years or older, without previous cancer or kidney failure.

Results: Among 1,319,308 individuals, the incidence rate of overall cancer was 17.3 per 1000 person-years. Higher ACR was positively associated with cancer risk [adjusted hazard ratio 1.08 (95% CI 1.06-1.10) per 8-fold increase in ACR]. No association of eGFR with overall cancer risk was seen. For site-specific cancers, lower eGFR was associated with urological cancer and multiple myeloma, whereas higher ACR was associated with many cancer types (kidney, head/neck, colorectal, liver, pancreas, bile duct, stomach, larynx, lung, hemolymphatic, leukaemia, and multiple myeloma). Results were similar in a 1-year landmark analysis.

Discussion: Albuminuria, but not necessarily eGFR, was independently associated with the subsequent risk of cancer. Our results warrant an investigation into mechanisms that explain the link between albuminuria and cancer.

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Conflict of interest statement

Competing interests: Dr. Ärnlöv has received lecturing fees from AstraZeneca and Boehringer Ingelheim and served on advisory boards for AstraZeneca, Boehringer Ingelheim and Astella, all unrelated to the present paper. Dr. Bell has received consultancy fees from Astra Zeneca, GSK and Bayer. Dr. Staplin has received funding in the form of grants from Boehringer Ingelheim, Eli Lilly, and Novo Nordisk. She follows a long-term departmental policy to decline honoraria from the drug and food industry, except for reasonable travel expenses for meetings. All other authors have no disclosures to report. Consent for publication: Not applicable, all aggregate data. Ethics approval and consent to participate: This study was approved for use of de-identified or limited data with a waiver of informed consent by the institutional review board at New York University. All methods were performed in accordance with the relevant guidelines and regulations.

Figures

Fig. 1
Fig. 1. Adjusted hazard ratios of overall cancer using linear spline models in the ACR population.
a Hazard ratios for overall cancer and ACR were adjusted for age, sex, body mass index, hypertension, diabetes, total cholesterol, use of aspirin or glucocorticoids, history of cardiovascular disease, current and former smoking, and eGFR. b Hazard ratios for overall cancer and eGFR were adjusted for age, sex, body mass index, hypertension, diabetes, total cholesterol, use of aspirin or glucocorticoids, history of cardiovascular disease, current and former smoking, and ACR.
Fig. 2
Fig. 2. Adjusted hazard ratios of site-specific cancers in the ACR population.
a Hazard ratios per 8-fold increase in ACR adjusted for age, sex, body mass index, hypertension, diabetes, total cholesterol, use of aspirin or glucocorticoids, history of cardiovascular disease, current and former smoking, and eGFR. b Hazard ratio per 15 ml/min/1.73 m2 decrease in eGFR creatinine in eGFR<60 ml/min/1.73 m2 adjusted for age, sex, body mass index, hypertension, diabetes, total cholesterol, use of aspirin or glucocorticoids, history of cardiovascular disease, current and former smoking, and ACR.
See this image and copyright information in PMC

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