Cancer Survivors Aged 40 Years or Elder are Associated with High Risk of Chronic Kidney Disease: The 2010-2012 Korean National Health and Nutrition Examination Survey

  • Shin, Hyun-Young (Department of Family Medicine, Severance Hospital) ;
  • Linton, John A. (Department of Family Medicine, Severance Hospital) ;
  • Shim, Jae-Yong (Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicin) ;
  • Kang, Hee-Taik (Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicin)
  • Published : 2015.03.09


Background: The number of cancer survivors is increasing globally and recently, higher rates of comorbidities in cancer survivors have been reported. However, no studies have investigated whether cancer survivors have a higher risk of chronic kidney disease (CKD). Accordingly, our study evaluated the association between cancer survivors and the risk of CKD using the 2010-2012 Korean National Health and Nutrition Examination Survey. Materials and Methods: A total of 11,407 participants aged 40 years and over were categorized into two groups according to cancer experience. Multiple variables were compared and the odds ratios (ORs) for CKD prevalence were calculated using a weighted logistic regression analysis between the two groups. Results: Cancer survivors were older than were those in the non-cancer group, on average, the percentages of glomerular filtration rate(GFR) lower than $60mL/min/1.73m^2$, proteinuria, and CKD were significantly higher in cancer survivors when compared to controls. Weighted logistic regression analyses demonstrated that cancer survivors had a higher risk for CKD after adjusting for multiple variables (OR (95% confidence interval), 2.88 (1.48-5.59)). Conclusions: Our study demonstrated a possible association between CKD and cancer survival in Korean adults. Identifying and correcting risk factors for cancer survivors would positively affect prevention of CKD and result in a better cancer prognosis.


  1. Airy M, Raghavan R, Truong LD, et al (2013). Tubulointerstitial nephritis and cancer chemotherapy: update on a neglected clinical entity. Nephrol Dial Transplant, 28, 2502-9.
  2. Athyros VG, Katsiki N, Doumas M, et al (2013). Effect of tobacco smoking and smoking cessation on plasma lipoproteins and associated major cardiovascular risk factors: a narrative review. Curr Med Res Opin, 29, 1263-74.
  3. Cengiz K (2002). Increased incidence of neoplasia in chronic renal failure (20-year experience). Int Urol Nephrol, 33, 121-6.
  4. Centers for Disease Control and Prevention (CDC) (2011). Cancer survivors-United States, 2007. MMWR. Morbidity and mortality weekly report, 60, 269-72.
  5. Dekkers IA, Blijdorp K, Cransberg K, et al (2013). Long-term nephrotoxicity in adult survivors of childhood cancer. Clin J Am Soc Nephrol, 8, 922-9.
  6. Demark-Wahnefried W, Aziz NM, Rowland JH, et al (2005). Riding the crest of the teachable moment: promoting longterm health after the diagnosis of cancer. J Clin Oncol, 23, 5814-30.
  7. Denlinger CS, Carlson RW, Are M, et al (2014). Survivorship: introduction and definition. Clinical practice guidelines in oncology. J Natl Compr Canc Netw, 12, 34-45.
  8. Duffy SA, Terrell JE, Valenstein M, et al (2002). Effect of smoking, alcohol, and depression on the quality of life of head and neck cancer patients. Gen Hosp Psychiatry, 24, 140-7.
  9. Fedirko V, Tramacere I, Bagnardi V, et al (2011). Alcohol drinking and colorectal cancer risk: an overall and doseresponse meta-analysis of published studies. Ann Oncol, 22, 1958-72.
  10. Foundation NK (2002). K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis, 39, 1-266.
  11. Grewal P, Viswanathen VA (2012). Liver cancer and alcohol. Clin Liver Dis, 16, 839-50.
  12. Gritz ER, Nisenbaum R, Elashoff RE, et al (1991). Smoking behavior following diagnosis in patients with stage I nonsmall cell lung cancer. Cancer Causes Control, 2,105-12.
  13. Hounshell J, Tomori C, Newlin R, et al (2001). Changes in finances, insurance, employment, and lifestyle among persons diagnosed with hairy cell leukemia. Oncologist, 6, 435-40.
  14. Imai E, Horio M, Nitta K, et al (2007). Estimation of glomerular filtration rate by the MDRD study equation modified for Japanese patients with chronic kidney disease. Clin Exp Nephrol, 11, 41-50.
  15. Jha V, Garcia-Garcia G, Iseki K, et al (2013). Chronic kidney disease: global dimension and perspectives. Lancet, 382, 260-72.
  16. Johansen KL (2007). Exercise in the end-stage renal disease population. J Am Soc Nephrol, 18, 1845-54.
  17. Jorgensen L, Heuch I, Jenssen T, et al (2008). Association of albuminuria and cancer incidence. J Am Soc Nephrol, 19, 992-8.
  18. Levey AS, Bosch JP, Lewis JB, et al (1999). A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med, 130, 461-70.
  19. Levey AS, Eckardt KU, Tsukamoto Y, et al (2005). Definition and classification of chronic kidney disease: a position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int, 67, 2089-100.
  20. Liu Y, Hu F, Li D, et al (2011). Does physical activity reduce the risk of prostate cancer? A systematic review and metaanalysis. Eur Urol, 60, 1029-44.
  21. Maisonneuve P, Agodoa L, Gellert R, et al (1999). Cancer in patients on dialysis for end-stage renal disease: an international collaborative study. Lancet, 354, 93-9.
  22. Maskarinec G, Murphy S, Shumay DM, et al (2001). Dietary changes among cancer survivors. Eur J Cancer Care, 10,12-20.
  23. Ministry of health and welfare, N.C.C. Cancer Fact and Figures 2012 in the republic of Korea
  24. Ogle KS, Swanson GM, Woods N, et al (2000). Cancer and comorbidity: redefining chronic diseases. Cancer, 88, 653-63.<653::AID-CNCR24>3.0.CO;2-1
  25. Quarmby S, Kumar P, Kumar S (1999). Radiation-induced normal tissue injury: role of adhesion molecules in leukocyte-endothelial cell interactions. Int J Cancer, 82, 385-95.<385::AID-IJC12>3.0.CO;2-5
  26. Siddik ZH (2005). Mechanisms of action of cancer chemotherapeutic agents: DNA-Interactive alkylating agents and antitumour platinum-based drugs. Cancer Handbook, Wiley, New Jersey.
  27. Sprague BL, Trentham-Dietz A, Nichols HB, et al (2010). Change in lifestyle behaviors and medication use after a diagnosis of ductal carcinoma in situ. Breast Cancer Res Treat, 124, 487-95.
  28. Steele MR, Belostotsky V, Lau KK (2012). The dangers of substance abuse in adolescents with chronic kidney disease: a review of the literature. Cannt J, 22,15-22.
  29. Stump CS (2011). Physical activity in the prevention of chronic kidney disease. Cardiorenal Med, 1, 164-73.
  30. Thomas F Babor, John CH-B, J BS, et al (2001). AUDIT, the alcohol use disorders identification test : guidelines for use in primary care. World Health Organization, Dept. of mental health and substance dependence, Geneva, Switzerland.
  31. Vajdic CM, McDonald SP, McCredie MR, et al (2006). Cancer incidence before and after kidney transplantation. JAMA, 296, 2823-31.
  32. White SL, Polkinghorne KR, Cass A, et al (2009). Alcohol consumption and 5-year onset of chronic kidney disease: the AusDiab study. Nephrol Dial Transplant, 24, 2464-72.
  33. Willi C, Bodenmann P, Ghali WA, et al (2007). Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA, 298, 2654-64.
  34. Wolin KY, Yan Y, Colditz GA, et al (2009). Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer, 100, 611-6.
  35. Wu Y, Zhang D, Kang S (2013). Physical activity and risk of breast cancer: a meta-analysis of prospective studies. Breast Cancer Res Treat, 137, 869-82.
  36. Xin X, He J, Frontini MG, et al (2001). Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension, 38, 1112-7.
  37. Yao X, Panichpisal K, Kurtzman N, et al (2007). Cisplatin nephrotoxicity: a review. Am J Med Sci, 334, 115-24.

Cited by

  1. Relationship between body mass index and renal function deterioration among the Taiwanese chronic kidney disease population vol.8, pp.1, 2018,