Abstract
BACKGROUND: Colorectal cancer survival has improved in recent decades but there are concerns that survivors may develop kidney problems due to adverse effects of cancer treatment or complications of the cancer itself. We quantified the risk of acute kidney injury (AKI) in colorectal cancer survivors compared to people with no prior cancer.
METHODS: Retrospective matched cohort study using electronic health record primary care data from the Clinical Practice Research Datalink GOLD linked to hospital data in England (HES-APC). Individuals with colorectal cancer between 1997-2018 were individually matched on age, sex, and GP practice to people with no prior cancer. We used Cox models to estimate hazard ratios for an incident hospital diagnosis of AKI in colorectal cancer survivors compared to individuals without cancer, overall and stratified by time since diagnosis adjusted for other individual-level factors (adj-HR).
RESULTS: Twenty thousand three hundred forty colorectal cancer survivors were matched to 100,058 cancer-free individuals. Colorectal cancer survivors were at increased risk of developing AKI compared to people without cancer (adj-HR = 2.16; 95%CI 2.05-2.27). The HR was highest in the year after diagnosis (adj-HR 7.47, 6.66-8.37), and attenuated over time, but there was still increased AKI risk > 5 years after diagnosis (adj-HR = 1.26, 1.17-1.37). The association between colorectal cancer and AKI was greater for younger people, men, and those with pre-existing chronic kidney disease.
CONCLUSIONS: Colorectal cancer survivors were at increased risk of AKI for several years after cancer diagnosis, suggesting a need to prioritise monitoring, prevention, and management of kidney problems in this group of cancer survivors.
| Original language | English |
|---|---|
| Article number | 839 |
| Number of pages | 10 |
| Journal | BMC Cancer |
| Volume | 23 |
| Issue number | 1 |
| Early online date | 7 Sept 2023 |
| DOIs | |
| Publication status | Published - 7 Sept 2023 |
| Externally published | Yes |
Data Availability Statement
The data that support the findings of this study but are not publicly available due to CPRD licencing restrictions. Study code lists for are available for download at the on the Electronic Health Records Research Group Data Compass: https://doi.org/10.17037/DATA.00002792.Funding
KB is funded by a Wellcome senior research fellowship (grant number 220283/z/20/z) and during the course of this work also received funding from a Sir Henry Dale fellowship jointly funded by Wellcome and the Royal Society (grant number 107731/z/15/z). The funder had no role in study design, data collection, data analysis, interpretation of the data or writing of the manuscript. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
Keywords
- Male
- Humans
- Cancer Survivors
- Cohort Studies
- Retrospective Studies
- Survivors
- Acute Kidney Injury/epidemiology
- Colorectal Neoplasms/complications
