Factors Associated With Advanced Colorectal Neoplasia in Patients With CKD

Au, Eric; Wong, Germaine; Howard, Kirsten; Chapman, Jeremy R.; Castells, Antoni; Roger, Simon D.; Bourke, Michael J.; Macaskill, Petra; Turner, Robin; Lim, Wai H.; Diekmann, Fritz; Cross, Nicholas B; Sen, Sayan; Allen, Richard D.; Chadban, Steven J.; Pollock, Carol; Tong, Allison; Teixeira‐Pinto, Armando; Yang, Pengyi; Kieu, Anh; James, Laura; Craig, Jonathan C.

doi:10.1053/j.ajkd.2021.07.011

Cited by 9 publications

(8 citation statements)

References 31 publications

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“…This mechanism may explain why the CKD population has a higher incidence rate of colorectal cancer [ 3 , 4 ]. The influenza vaccine may be a convenient and cost-effective method to protect individuals with CKD.…”

Section: Discussionmentioning

confidence: 99%

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Protective Effects of Influenza Vaccine against Colorectal Cancer in Populations with Chronic Kidney Disease: A Nationwide Population-Based Cohort Study

Chen

Hao

Hong

et al. 2023

Cancers

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Chronic kidney disease (CKD) is associated with malignancy, including colorectal cancer, via the potential mechanism of chronic inflammation status. This study aimed to determine whether influenza vaccines can reduce the risk of colorectal cancer in patients with CKD. Our cohort study enrolled 12,985 patients older than 55 years with a diagnosis of CKD in Taiwan from the National Health Insurance Research Database at any time from 1 January 2001 to 31 December 2012. Patients enrolled in the study were divided into a vaccinated and an unvaccinated group. In this study, 7490 and 5495 patients were unvaccinated and vaccinated, respectively. A propensity score was utilized to reduce bias and adjust the results. Cox proportional hazards regression was used to estimate the correlation between the influenza vaccine and colorectal cancer in patients with CKD. The results showed that the influenza vaccine exerted a protective effect against colorectal cancer in populations with CKD. The incidence rate of colon cancer in the vaccinated group was significantly lower than in the unvaccinated group, with an adjusted hazard rate (HR) of 0.38 (95% CI: 0.30–0.48, p < 0.05). After the propensity score was adjusted for Charlson comorbidity index, age, sex, dyslipidemia, hypertension, diabetes, monthly income, and level of urbanization, the dose-dependent effect was found, and it revealed adjusted HRs of 0.74 (95% CI: 0.54–1.00, p < 0.05), 0.41 (95% CI: 0.30–0.57, p < 0.001), 0.16 (95% CI: 0.11–0.25, p < 0.001) for one, two to three, and four or more vaccinations, respectively. In summary, the influenza vaccine was found to be associated with a reduced risk of colorectal cancer in CKD patients. This study highlights the potential chemopreventive effect of influenza vaccination among patients with CKD. Future studies are required to determine whether the aforementioned relationship is a causal one.

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Section: Discussionmentioning

confidence: 99%

“…Patients with CKD are twice as likely to develop colorectal cancer than the general population [ 3 ]. Compared with that in the general population, the standardized incidence ratio of colorectal cancer in patients with predialytic CKD was reported to be 1.60 (95% CI: 1.45–1.74) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Protective Effects of Influenza Vaccine against Colorectal Cancer in Populations with Chronic Kidney Disease: A Nationwide Population-Based Cohort Study

Chen

Hao

Hong

et al. 2023

Cancers

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“…Firstly, the primary kidney disease was glomerulonephritis treated with steroids and cyclophosphamide, whereas the pretransplant immunosuppressive treatment was shown to increase the cancer risk[ 12 , 13 ]. Secondly, the use of azathioprine could be an independent risk factor for advanced colorectal neoplasia in KTRs[ 14 ]. The patient has received this medication for 5 years because of the planned conception.…”

Section: Discussionmentioning

confidence: 99%

Transplanted kidney loss during colorectal cancer chemotherapy: A case report

Pośpiech¹,

Kolonko²,

Nieszporek³

et al. 2022

WJCC

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BACKGROUND The overall risk of de novo malignancies in kidney transplant recipients (KTRs) is higher than that in the general population. It is associated with long-lasting exposure to immunosuppressive agents and impaired oncological vigilance due to chronic kidney disease. Colorectal cancer (CRC), frequently diagnosed in an advanced stage, is one of the most common malignancies in this cohort and is associated with poor prognosis. Still, because of the scarcity of data concerning adjuvant chemotherapy in this group, there are no clear guidelines for the specific management of the CRCs in KTRs. We present a patient who lost her transplanted kidney shortly after initiation of adjuvant chemotherapy for colon cancer. CASE SUMMARY A 36-year-old woman with a medical history of kidney transplantation (2005) because of end-stage kidney disease, secondary to chronic glomerular nephritis, and long-term immunosuppression was diagnosed with locally advanced pT 4A N 1B M 0 (clinical stage III) colon adenocarcinoma G2. After right hemicolectomy, the patient was qualified to receive adjuvant chemotherapy that consisted of oxaliplatin, leucovorin and 5-fluorouracil (FOLFOX-4). The deterioration of kidney graft function after two cycles caused chemotherapy cessation and initiation of hemodialysis therapy after a few months. Shortly after that, the patient started palliative chemotherapy because of cancer recurrence with intraperitoneal spread. CONCLUSION Initiation of adjuvant chemotherapy for colon cancer increases the risk of rapid kidney graft loss driven also by under-immunosuppression.

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“…We assessed the incidence of all cancers and site‐specific cancers. Site‐specific cancers included colorectal, gastric and kidney cancers, which have higher incidence rates than other cancers in Japan or have been reported to be associated with kidney failure 18‐20,26 . The secondary outcome was cancer mortality, defined as death due to any cancer.…”

Section: Methodsmentioning

confidence: 99%

“…Site-specific cancers included colorectal, gastric and kidney cancers, which have higher incidence rates than other cancers in Japan or have been reported to be associated with kidney failure. [18][19][20]26 The secondary outcome was cancer mortality, defined as death due to any cancer. The participants were followed up from the enrollment date until December 31, 2017, which was the latest date on which follow-up data were available at the time of analysis.…”

Section: Study Outcomes and Follow-up Periodmentioning

confidence: 99%

Association of kidney function with cancer incidence and its influence on cancer risk of smoking: The Japan Multi‐Institutional Collaborative Cohort Study

Kurasawa

Imaizumi

Maruyama

et al. 2023

Intl Journal of Cancer

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The association between kidney function and cancer incidence is inconsistent among previous reports, and data on the Japanese population are lacking. It is unknown whether kidney function modifies the cancer risk of other factors. We aimed to evaluate the association of estimated glomerular filtration rate (eGFR) with cancer incidence and mortality in 55 242 participants (median age, 57 years; 55% women) from the Japan Multi-Institutional Collaborative Cohort Study. We also investigated differences in cancer risk factors between individuals with and without kidney dysfunction.During a median 9.3-year follow-up period, 4278 (7.7%) subjects developed cancer.

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Factors Associated With Advanced Colorectal Neoplasia in Patients With CKD

Cited by 9 publications

References 31 publications

Protective Effects of Influenza Vaccine against Colorectal Cancer in Populations with Chronic Kidney Disease: A Nationwide Population-Based Cohort Study

Protective Effects of Influenza Vaccine against Colorectal Cancer in Populations with Chronic Kidney Disease: A Nationwide Population-Based Cohort Study

Transplanted kidney loss during colorectal cancer chemotherapy: A case report

Association of kidney function with cancer incidence and its influence on cancer risk of smoking: The Japan Multi‐Institutional Collaborative Cohort Study

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