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2014 ; 25
(10
): 2335-41
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Polycystic kidney disease and cancer after renal transplantation
#MMPMID24854270
Wetmore JB
; Calvet JP
; Yu AS
; Lynch CF
; Wang CJ
; Kasiske BL
; Engels EA
J Am Soc Nephrol
2014[Oct]; 25
(10
): 2335-41
PMID24854270
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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.
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