Patients with urothelial carcinoma have poor renal outcome regardless of whether they receive nephrouretectomy
Journal
Oncotarget
Journal Volume
7
Journal Issue
38
Pages
61679-61689
Date Issued
2016
Author(s)
Abstract
The association between urothelial carcinoma (UC) and subsequent ESRD incidence has not been confirmed. This was a population-based study using claims data from the Taiwan National Health Institutes from 1998 to 2010. The study cohort consisted of 26,017 patients with newly diagnosed UC and no history of ESRD, and the comparison cohort consisted of 208,136 matched enrollees without UC. The incidence of ESRD was ascertained through cross-referencing with a registry for catastrophic illnesses. Cox proportional hazard regression analysis was used to estimate the risk of ESRD associated with UC and UC subtype. A total of 979 patients (3.76%) from the UC group and 1,829 (0.88%) from the comparison group developed ESRD. Multivariable analysis indicated that compared with the comparison group, the hazard ratios (HRs) for ESRD were 7.75 (95% confidence interval [CI]: 6.84 to 8.78) and 3.12 (95% CI: 6.84 to 8.78) in the cohort with upper urinary tract UC (UT-UC) and bladder UC (B-UC), respectively. In addition, there were significantly increased risks for ESRD in UC patients receiving and not receiving nephrouretectomies or aristolochic acids (AA). Moreover, the UC patients receiving segmental ureterectomy and ureteral reimplantation had approximately 1.3-fold and 2.4-fold increased risk for ESRD after control for confounders, respectively. Thus, our data indicate that UT-UC and B-UC independently increased the risk for ESRD in patients after considering about nephrouretectomies or aristolochic acids (AA). In addition, UC patients receiving segmental ureterectomy and ureteral reimplantation had increased risk for ESRD.
Subjects
Chronic kidney disease; End stage renal disease; Nephrouretectomy; Urothelial carcinoma
SDGs
Other Subjects
aristolochic acid; aristolochic acid I; adult; aged; Article; comorbidity; controlled study; disease association; disease classification; disease registry; end stage renal disease; female; high risk patient; human; major clinical study; male; nephrouretectomy; outcome assessment; risk assessment; transitional cell carcinoma; ureter surgery; urologic surgery; bladder tumor; chemistry; chronic kidney failure; cohort analysis; complication; kidney; middle aged; multivariate analysis; pathology; proportional hazards model; register; retrospective study; Taiwan; treatment outcome; ureter; urothelium; Adult; Aged; Aristolochic Acids; Cohort Studies; Female; Humans; Kidney; Kidney Failure, Chronic; Male; Middle Aged; Multivariate Analysis; Proportional Hazards Models; Registries; Retrospective Studies; Taiwan; Treatment Outcome; Ureter; Urinary Bladder Neoplasms; Urothelium
Publisher
Impact Journals LLC
Type
journal article