Original InvestigationKidney Function, Proteinuria, and Cancer Incidence: The Korean Heart Study
Section snippets
Study Population
The Korean Heart Study included 430,920 individuals (266,782 men and 164,138 women) who had voluntarily undergone a health checkup in 18 centers located in the capital, Seoul, and 6 provinces in South Korea in 1996 to 2004.32 We excluded participants with a history of cancer diagnosis at baseline (n = 5,040) and missing information for serum creatinine (n = 57,556) and urine dipstick test results (n = 125,741), leaving the final study population of 242,583 participants (Fig S1, available as online
Baseline Characteristics
Mean age of study participants was 44.4 ± 9.6 years, and 33.1% were women. Current smoking was substantially more common in men (55.1%) than in women (4.5%). Average eGFR was 92.0 ± 13.8 mL/min/1.73 m2. Of the study participants, 1.0% had eGFRs < 60 mL/min/1.73 m2 or proteinuria by dipstick test (≥1+). Those with lower eGFRs (<60 mL/min/1.73 m2) or higher proteinuria (≥1+) were more likely to be older and have diabetes, hypertension, and hypercholesterolemia compared with those with higher eGFRs (≥60
Discussion
In this large Korean cohort study, we observed that both low eGFR and high proteinuria were associated with cancer incidence, with some unique patterns for each CKD measure. Overall, the associations were much more robust and consistent for high proteinuria than for low eGFR. Even trace proteinuria contributed to increased overall cancer risk, and proteinuria was associated with a broad range of site-specific cancers. For eGFR, when we accounted for potential confounders, the lowest risk was
Acknowledgements
Support: This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1631020) and by a grant of the Korean Health, Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI14C2686).
Financial Disclosure: The authors declare that they have no other relevant financial interests.
Contributions: Study concept and design: YM, KM, SHJ; data acquisition: SL, SHJ; data analysis/interpretation: YM, KM, SHB, YS,
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