TY - JOUR
T1 - Trends and outcomes With kidney failure from antineoplastic treatments and urinary tract cancer in France
AU - French REIN registry
AU - Mansouri, Imène
AU - de Pinho, Natalia Alencar
AU - Snanoudj, Renaud
AU - Jacquelinet, Christian
AU - Lassalle, Mathilde
AU - Béchade, Clémence
AU - Vigneau, Cécile
AU - de Vathaire, Florent
AU - Haddy, Nadia
AU - Stengel, Bénédicte
N1 - Publisher Copyright:
© 2020 by the American Society of Nephrology.
PY - 2020/4/7
Y1 - 2020/4/7
N2 - Background and objectives Cancer survival is improving along With an increase in the potential for adverse kidney effects from antineoplastic treatments or nephrectomy. We sought to describe recent trends in the incidence of kidney failure related to antineoplastic treatments and urinary tract cancers and evaluate patient survival and kidney transplantation access. Design, setting, participants, & measurements We used the French Renal Epidemiology and Information Networkregistrytoidentifypatientswith kidney failure related to antineoplastic treatments or urinary tract cancer from 2003 to 2015. We identified 287 and 1157 cases With nephrotoxin-and urinary tract cancer–related kidney failure, respectively. The main study outcomes Were death and kidney transplantation. After matching cases to two to ten controls (n=11,678) With other kidney failure causes for age, sex, year of dialysis initiation, and diabetes status, We estimated subdistribution hazard ratios (SHR) of each outcome separately for patients With and Without active malignancy. Results The mean age-and sex-adjusted incidence of nephrotoxin-related kidney failure Was 0.43 (95% CI, 0.38 to 0.49) per million inhabitants and 1.80 (95% CI, 1.68 to 1.90) for urinary tract cancer–related kidney failure; they increased significantly by 5% and 2% annually, respectively, during 2006–2015. Compared With matched controls, age-, sex-, and comorbidity-adjusted SHRs for mortality in patients With nephrotoxin-related kidney failure Were 4.2 (95% CI, 3.2 to 5.5) and 1.4 (95% CI, 1.0 to 2.0) for those With and Without active malignancy, respectively; for those With urinary tract cancer, SHRs Were 2.0 (95% CI, 1.7 to 2.2) and 1.1 (95% CI, 0.9 to 1.2). The corresponding SHRs for transplant Wait-listing Were 0.19 (95% CI, 0.11 to 0.32) and 0.62 (95% CI, 0.43 to 0.88) for nephrotoxin-related kidney failure cases and 0.28 (95% CI, 0.21 to 0.37) and 0.47 (95% CI, 0.36 to 0.60) for urinary tract cancer cases. Once on the Waiting list, access to transplantation did not differ significantly between cases and controls. Conclusions Cancer-related kidney failure is slowly but steadily increasing. Mortality does not appear to be increased among patients Without active malignancy at dialysis start, but their access to kidney transplant remains limited.
AB - Background and objectives Cancer survival is improving along With an increase in the potential for adverse kidney effects from antineoplastic treatments or nephrectomy. We sought to describe recent trends in the incidence of kidney failure related to antineoplastic treatments and urinary tract cancers and evaluate patient survival and kidney transplantation access. Design, setting, participants, & measurements We used the French Renal Epidemiology and Information Networkregistrytoidentifypatientswith kidney failure related to antineoplastic treatments or urinary tract cancer from 2003 to 2015. We identified 287 and 1157 cases With nephrotoxin-and urinary tract cancer–related kidney failure, respectively. The main study outcomes Were death and kidney transplantation. After matching cases to two to ten controls (n=11,678) With other kidney failure causes for age, sex, year of dialysis initiation, and diabetes status, We estimated subdistribution hazard ratios (SHR) of each outcome separately for patients With and Without active malignancy. Results The mean age-and sex-adjusted incidence of nephrotoxin-related kidney failure Was 0.43 (95% CI, 0.38 to 0.49) per million inhabitants and 1.80 (95% CI, 1.68 to 1.90) for urinary tract cancer–related kidney failure; they increased significantly by 5% and 2% annually, respectively, during 2006–2015. Compared With matched controls, age-, sex-, and comorbidity-adjusted SHRs for mortality in patients With nephrotoxin-related kidney failure Were 4.2 (95% CI, 3.2 to 5.5) and 1.4 (95% CI, 1.0 to 2.0) for those With and Without active malignancy, respectively; for those With urinary tract cancer, SHRs Were 2.0 (95% CI, 1.7 to 2.2) and 1.1 (95% CI, 0.9 to 1.2). The corresponding SHRs for transplant Wait-listing Were 0.19 (95% CI, 0.11 to 0.32) and 0.62 (95% CI, 0.43 to 0.88) for nephrotoxin-related kidney failure cases and 0.28 (95% CI, 0.21 to 0.37) and 0.47 (95% CI, 0.36 to 0.60) for urinary tract cancer cases. Once on the Waiting list, access to transplantation did not differ significantly between cases and controls. Conclusions Cancer-related kidney failure is slowly but steadily increasing. Mortality does not appear to be increased among patients Without active malignancy at dialysis start, but their access to kidney transplant remains limited.
UR - http://www.scopus.com/inward/record.url?scp=85083003531&partnerID=8YFLogxK
U2 - 10.2215/CJN.10230819
DO - 10.2215/CJN.10230819
M3 - Article
C2 - 32144099
AN - SCOPUS:85083003531
SN - 1555-9041
VL - 15
SP - 484
EP - 492
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 4
ER -