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

Yejin Mok¹, Aditya Surapaneni², Yingying Sang³, Josef Coresh³, Morgan E Grams², Kunihiro Matsushita¹, Shoshana H Ballew⁴, Natalia Alencar de Pinho⁵, Johan Ärnlöv^{6

7}, Sandhi M Barreto⁸, Samira Bell⁹, Hermann Brenner¹⁰, Juan-Jesus Carrero^{11

12}, Rajkumar Chinnadurai¹³, Elizabeth Ciemins¹⁴, Ron T Gansevoort¹⁵, Simerjot K Jassal^{16

17}, Keum Ji Jung¹⁸, H Lester Kirchner¹⁹, Tsuneo Konta²⁰, Csaba P Kovesdy²¹, Li Luo¹⁵, Krutika Pandit², Mahboob Rahman²², Cassianne Robinson-Cohen²³, Charumathi Sabanayagam^{24

25}, Ulla T Schultheiss^{26

27

28}, Michael Shlipak^{29

30}, Natalie Staplin³¹, Marcello Tonelli³², Angela Yee-Moon Wang³³, Chi-Pang Wen³⁴, Mark Woodward^{35

36}, Jennifer S Lees^{37

38}; CKD Prognosis Consortium

Collaborators, Affiliations

Collaborators

CKD Prognosis Consortium:
Katie Harris, Hisatomi Arima, John Chalmers, Morgan Grams, Elvis Akwo, Jing He, Anita Lloyd, Natalia Alencar de Pinho, Marie Metzger, Bénédicte Stengel, Aghilès Hamroun, Ziad Massy, Panduranga Rao, Giselle Sosa, Vallabh Shah, Jesse Hsu, Alvaro Vigo, José Geraldo Mill, Paulo Lotufo, Scheine Canhada, Ben Schöttker, Hannah Stocker, Dietrich Rothenbacher, Markus P Schneider, Anna Köttgen, Heike Meiselbach, Kai-Uwe Eckardt, Jamie Green, Alexander R Chang, Gurmukteshwar Singh, Emilie Lambourg, Shona Livingstone, Colin Palmer, Ewan Pearson, Sun Ha Jee, Heejin Kimm, Ronit Katz, Carina Flaherty, Jeff Mohl, Lyanne M Kieneker, Stephan Jl Bakker, Bert van der Vegt, Rudolf A de Boer, Jaclyn Bergstrom, Joachim Ix, Keiichi Sumida, Prabin Shrestha, Ching-Yu Cheng, Tien Yin Wong, Pavitra Thyagarajan, William Herrington, Martin J Landray, Colin Baigent, Philip Kalra, Darren Green, Smeeta Sinha, James Ritchie, Min-Kung Tsai, Jennifer Lees, Anders Larsson, Vilmantas Giedraitis, Andrew S Levey, Dorothea Nitsch, Michael G Shlipak

Affiliations

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiologyand Clinical Research, Baltimore, MD, USA.
² Division of Precision Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA.
³ Optimal Aging Institute, New York University Grossman School of Medicine, New York, NY, USA.
⁴ Optimal Aging Institute, New York University Grossman School of Medicine, New York, NY, USA. Shoshana.Ballew@nyulangone.org.
⁵ Centre for research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France.
⁶ Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden.
⁷ School of Health and Social Studies, Dalarna University, Falun, Sweden.
⁸ Department of Preventive Medicine, School of Medicine and Hospital das Clínicas/Empresa Brasileira de Serviços Hospitalares and Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
⁹ Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK.
¹⁰ Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, and Network Aging Research, Heidelberg University, Heidelberg, Germany.
¹¹ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Huddinge, Sweden.
¹² Division of Nephrology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
¹³ Department of Renal Medicine, Salford Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, UK.
¹⁴ AMGA (American Medical Group Association), Alexandria, VA, USA.
¹⁵ Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
¹⁶ University of California San Diego, La Jolla, CA, USA.
¹⁷ San Diego VA Health Care System, San Diego, CA, USA.
¹⁸ Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
¹⁹ Department of Population Health Sciences, Research Institute, Geisinger, Danville, PA, USA.
²⁰ Department of Public Health and Hygiene, Yamagata University Faculty of Medicine, Yamagata, Japan.
²¹ Medicine-Nephrology, Memphis Veterans Affairs Medical Center and University of Tennessee Health Science Center, Memphis, TN, USA.
²² Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, OH, USA.
²³ Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
²⁴ Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
²⁵ Ophthalmology and Visual Sciences Academic Clinical Programme (EYE-ACP), Duke-NUS Medical School, Singapore, Singapore.
²⁶ Institute of Genetic Epidemiology, Department of Data Driven Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
²⁷ Department of Medicine IV, Nephrology and Primary Care, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.
²⁸ Synlab, MVZ Humangenetik Freiburg GmbH, Freiburg, Germany.
²⁹ Kidney Health Research Collaborative, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
³⁰ General Internal Medicine Division, Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
³¹ Renal Studies Group, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
³² Department of Medicine, University of Calgary, Calgary, AB, Canada.
³³ Department of Renal Medicine, Singapore General Hospital, Duke-National University of Singapore, Singapore, Singapore.
³⁴ Institute of Population Health Science, National Health Research Institutes/China Medical University Hospital, Zhunan, Taiwan.
³⁵ The George Institute for Global Health, University of New South Wales, Sydney, Australia.
³⁶ The George Institute for Global Health, Imperial College London, London, UK.
³⁷ School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
³⁸ Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.

PMID: 40914744
DOI: 10.1038/s41416-025-03140-z

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

Yejin Mok et al. Br J Cancer. 2025.

. 2025 Sep 6.

doi: 10.1038/s41416-025-03140-z. Online ahead of print.

Authors

Collaborators

CKD Prognosis Consortium:
Katie Harris, Hisatomi Arima, John Chalmers, Morgan Grams, Elvis Akwo, Jing He, Anita Lloyd, Natalia Alencar de Pinho, Marie Metzger, Bénédicte Stengel, Aghilès Hamroun, Ziad Massy, Panduranga Rao, Giselle Sosa, Vallabh Shah, Jesse Hsu, Alvaro Vigo, José Geraldo Mill, Paulo Lotufo, Scheine Canhada, Ben Schöttker, Hannah Stocker, Dietrich Rothenbacher, Markus P Schneider, Anna Köttgen, Heike Meiselbach, Kai-Uwe Eckardt, Jamie Green, Alexander R Chang, Gurmukteshwar Singh, Emilie Lambourg, Shona Livingstone, Colin Palmer, Ewan Pearson, Sun Ha Jee, Heejin Kimm, Ronit Katz, Carina Flaherty, Jeff Mohl, Lyanne M Kieneker, Stephan Jl Bakker, Bert van der Vegt, Rudolf A de Boer, Jaclyn Bergstrom, Joachim Ix, Keiichi Sumida, Prabin Shrestha, Ching-Yu Cheng, Tien Yin Wong, Pavitra Thyagarajan, William Herrington, Martin J Landray, Colin Baigent, Philip Kalra, Darren Green, Smeeta Sinha, James Ritchie, Min-Kung Tsai, Jennifer Lees, Anders Larsson, Vilmantas Giedraitis, Andrew S Levey, Dorothea Nitsch, Michael G Shlipak

Affiliations

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiologyand Clinical Research, Baltimore, MD, USA.
² Division of Precision Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA.
³ Optimal Aging Institute, New York University Grossman School of Medicine, New York, NY, USA.
⁴ Optimal Aging Institute, New York University Grossman School of Medicine, New York, NY, USA. Shoshana.Ballew@nyulangone.org.
⁵ Centre for research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France.
⁶ Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden.
⁷ School of Health and Social Studies, Dalarna University, Falun, Sweden.
⁸ Department of Preventive Medicine, School of Medicine and Hospital das Clínicas/Empresa Brasileira de Serviços Hospitalares and Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
⁹ Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK.
¹⁰ Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, and Network Aging Research, Heidelberg University, Heidelberg, Germany.
¹¹ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Huddinge, Sweden.
¹² Division of Nephrology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
¹³ Department of Renal Medicine, Salford Care Organisation, Northern Care Alliance NHS Foundation Trust, Salford, UK.
¹⁴ AMGA (American Medical Group Association), Alexandria, VA, USA.
¹⁵ Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
¹⁶ University of California San Diego, La Jolla, CA, USA.
¹⁷ San Diego VA Health Care System, San Diego, CA, USA.
¹⁸ Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
¹⁹ Department of Population Health Sciences, Research Institute, Geisinger, Danville, PA, USA.
²⁰ Department of Public Health and Hygiene, Yamagata University Faculty of Medicine, Yamagata, Japan.
²¹ Medicine-Nephrology, Memphis Veterans Affairs Medical Center and University of Tennessee Health Science Center, Memphis, TN, USA.
²² Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, OH, USA.
²³ Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
²⁴ Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
²⁵ Ophthalmology and Visual Sciences Academic Clinical Programme (EYE-ACP), Duke-NUS Medical School, Singapore, Singapore.
²⁶ Institute of Genetic Epidemiology, Department of Data Driven Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
²⁷ Department of Medicine IV, Nephrology and Primary Care, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.
²⁸ Synlab, MVZ Humangenetik Freiburg GmbH, Freiburg, Germany.
²⁹ Kidney Health Research Collaborative, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
³⁰ General Internal Medicine Division, Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
³¹ Renal Studies Group, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
³² Department of Medicine, University of Calgary, Calgary, AB, Canada.
³³ Department of Renal Medicine, Singapore General Hospital, Duke-National University of Singapore, Singapore, Singapore.
³⁴ Institute of Population Health Science, National Health Research Institutes/China Medical University Hospital, Zhunan, Taiwan.
³⁵ The George Institute for Global Health, University of New South Wales, Sydney, Australia.
³⁶ The George Institute for Global Health, Imperial College London, London, UK.
³⁷ School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
³⁸ Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.

PMID: 40914744
DOI: 10.1038/s41416-025-03140-z

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.

References

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

Collaborators

Affiliations

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

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Grants and funding

LinkOut - more resources

Full Text Sources

Research Materials

Miscellaneous