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Clinical Epidemiology
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Polycystic Kidney Disease and Cancer after Renal Transplantation

James B. Wetmore, James P. Calvet, Alan S.L. Yu, Charles F. Lynch, Connie J. Wang, Bertram L. Kasiske and Eric A. Engels
JASN October 2014, 25 (10) 2335-2341; DOI: https://doi.org/10.1681/ASN.2013101122
James B. Wetmore
*Department of Medicine, Division of Nephrology,
†The Kidney Institute,
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James P. Calvet
†The Kidney Institute,
‡Department of Biochemistry and Molecular Biology, and
§Department of Cancer Biology, University of Kansas School of Medicine, Kansas City, Kansas;
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Alan S.L. Yu
*Department of Medicine, Division of Nephrology,
†The Kidney Institute,
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Charles F. Lynch
‖Department of Epidemiology, University of Iowa, Iowa City, Iowa;
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Connie J. Wang
*Department of Medicine, Division of Nephrology,
†The Kidney Institute,
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Bertram L. Kasiske
¶Department of Medicine, Division of Nephrology, Hennepin County Medical Center, Minneapolis, Minnesota; and
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Eric A. Engels
**Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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Abstract

Autosomal dominant polycystic kidney disease (ADPKD), the most common form of polycystic kidney disease (PKD), is a disorder with characteristics of neoplasia. However, it is not known whether renal transplant recipients with PKD have an increased risk of cancer. Data from the Scientific Registry of Transplant Recipients, which contains information on all solid organ transplant recipients in the United States, were linked to 15 population-based cancer registries in the United States. For PKD recipients, we compared overall cancer risk with that in the general population. We also compared cancer incidence in PKD versus non-PKD renal transplant recipients using Poisson regression, and we determined incidence rate ratios (IRRs) adjusted for age, sex, race/ethnicity, dialysis duration, and time since transplantation. The study included 10,166 kidney recipients with PKD and 107,339 without PKD. Cancer incidence in PKD recipients was 1233.6 per 100,000 person-years, 48% higher than expected in the general population (standardized incidence ratio, 1.48; 95% confidence interval [95% CI], 1.37 to 1.60), whereas cancer incidence in non-PKD recipients was 1119.1 per 100,000 person-years. The unadjusted incidence was higher in PKD than in non-PKD recipients (IRR, 1.10; 95% CI, 1.01 to 1.20). However, PKD recipients were older (median age at transplantation, 51 years versus 45 years for non-PKD recipients), and after multivariable adjustment, cancer incidence was lower in PKD recipients than in others (IRR, 0.84; 95% CI, 0.77 to 0.91). The reason for the lower cancer risk in PKD recipients is not known but may relate to biologic characteristics of ADPKD or to cancer risk behaviors associated with ADPKD.

  • Copyright © 2014 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 25 (10)
Journal of the American Society of Nephrology
Vol. 25, Issue 10
October 2014
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Polycystic Kidney Disease and Cancer after Renal Transplantation
James B. Wetmore, James P. Calvet, Alan S.L. Yu, Charles F. Lynch, Connie J. Wang, Bertram L. Kasiske, Eric A. Engels
JASN Oct 2014, 25 (10) 2335-2341; DOI: 10.1681/ASN.2013101122

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Polycystic Kidney Disease and Cancer after Renal Transplantation
James B. Wetmore, James P. Calvet, Alan S.L. Yu, Charles F. Lynch, Connie J. Wang, Bertram L. Kasiske, Eric A. Engels
JASN Oct 2014, 25 (10) 2335-2341; DOI: 10.1681/ASN.2013101122
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More in this TOC Section

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