Cancer Risks, Mortality Vary With CKD Stage
Patients with chronic kidney disease (CKD) may be at increased risk for cancer. This study examined cancer incidence and mortality across the spectrum of CKD.

Patients were categorized as of the first date they had two eGFR assessments or were registered as receiving maintenance dialysis or having received a kidney transplant. eGFR levels were further categorized as: ?60, 45-59, 30-44, 15-29, or <15 mL/min/1.73m2 consistent with KDIGO stages G1/2, G3a, G3b, G4, and G5, respectively.

Fine and Gray subdistribution hazard models were used. Among 5,882,388 individuals with eGFR data, 29,809 receiving dialysis, and 4,951 having received a kidney transplant, there were 325,895 cancer diagnoses made over 29,993,847 person-years of follow-up. The cumulative incidence of cancer ranged between 10.8 to 15.3% in patients with kidney disease. The risks of bladder, kidney cancers and multiple myeloma were particularly elevated in CKD, and mortality from these malignancies increased with worsening kidney function.

Cancer-related mortality was significantly higher among patients with kidney disease, particularly urologic cancers and myeloma. Strategies to detect and manage these cancers in the CKD population are needed.