e16025 Background: Patients with ESRD on long term hemodialysis are known to be at an increased risk for renal cell carcinoma. We postulate that some component of chronic renal failure not corrected by dialysis might be the tumor-inducing factor. We sought to determine if chronic renal insufficiency is a risk factor for developing renal cell carcinoma. Methods: A case- control study was used to determine a relationship between renal carcinoma and glomerular filtration rate (MDRD) (eGFR) and using patients with prostate cancer as controls. 1,298 patients from the Columbia University Urologic Oncology Database were identified with either prostate or kidney cancer who had sufficient information to predict eGFR. eGFR calculations were performed for both groups. eGFR was divided into two groups based upon the cut-off value of ≥90. eGFR was also categorized according to the MDRD definitions of chronic kidney disease (CKD), CKD1–4 (values≥90, 60≤values<90, 30≤values<60, and values<30, respectively). Logistic regression techniques were used to quantify the association between pre-operative glomerular filtration rate and the presence of renal or prostate cancer. Results: The mean age of the prostate (n=713) and kidney (n=585) group was 59.9 and 61 years, respectively (p=0.041). The mean weight was 83.9 and 87 kg, respectively (p=0.005). The mean serum creatinine was 1.01 and 1.29 mg/dL, respectively (p<0.001). The mean eGFR was 85 and 73.8, respectively (p<0.001). Two models were fit to analyze the association of eGFR. The first model found eGFR <90 was significantly associated with the presence of a renal carcinoma when controlling for age and race (OR=1.93, CI=1.49–2.49). The second model investigated the eGFR-CKD categories while controlling for age and race and was able to predict the presence of renal cancer (p < 0.001). Patients with an eGFR value of 60≤X<90 had an OR of 1.47 (CI= 1.13–1.92) for renal cancer when compared to patients with normal eGFR levels. Patients with an eGFR value of 30≤X<60 and <30 had an OR of 6.26 (CI=4.10–9.55) and 21.11 (CI=4.87–91.42), respectively. Conclusions: Diminished renal function showed a significant association with the presence of renal cancer. Chronic renal insufficiency may be a risk factor for the development of renal carcinoma. No significant financial relationships to disclose.
An overview of renal insufficiency, race, and glomerular filtration rate calculation for the vascular surgeon
