Kidney Disease Patients Face Increased Risk of Developing Cancer, Study Shows

Fact checked on May 25, 2022 by Vivianna Shields, a journalist and fact-checker with experience in health and wellness publishing.

People with mild-to-moderate chronic kidney disease (CKD), and those who have received kidney transplants, may have an increased risk of developing cancer, new research shows. In some cases, people with CKD may have a heightened risk of death from certain cancers, as well.

The study, recently published in the American Journal of Kidney Diseases, brings to light the less well-known implications of CKD. Study authors note that while cardiovascular disease has traditionally been viewed as the main health risk associated with the disease, cancer isn't too far behind.

"We're now appreciating that not only do a large proportion [of kidney disease patients] develop cancer, but that they have particularly bad outcomes with cancer," Abhijat Kitchlu, MD, a nephrologist at the University of Toronto and lead author of the study, told Health. "We found in our study apart from a frequent diagnosis, these patients did worse compared to people with normal kidney function."

The increased risk of not only being diagnosed with but also dying from cancer suggests that new strategies to both detect and treat cancer in patients with kidney disease are needed. Here's a closer look at the connection between kidney disease and cancer—and what CKD patients can do to mitigate their risk.

Kidney Disease and Increased Cancer Risk

Prior to the new study, it was already well known that patients with CKD could be at a higher risk of cancer, according to Dr. Kitchlu. But clinical data was scant.

In order to get a better understanding of the cancer incidence and outcomes of patients with CKD, researchers conducted a population-based study of patients in Ontario, Canada. Using health care database records from 2007 to 2016, study authors categorized patients according to kidney function (via blood test data), or by those who received maintenance dialysis or a kidney transplant.

In data from more than five million patients, researchers found that 10%–15% of those with kidney disease later developed cancer. The risk of cancer was higher in people with mild-to-moderate kidney disease (characterized as CKD G3a) and patients who had undergone kidney transplants, than people without kidney disease.

Some patients with moderate-to-severe kidney disease—specifically CKD stages G3a to 4—and those who received kidney transplants also had a higher risk of death due to cancer, particularly from bladder and kidney cancer, and multiple myeloma.

According to study authors, the findings suggest that there are shortcomings in the ways health care providers are able to diagnose and treat cancer in patients with less severe forms of the disease.

"Because patients with mild or moderate kidney disease deal with other medical problems like diabetes, hypertension, and other cardiovascular issues, routine things like cancer screenings may fall to the back burner or be prioritized less compared to patients who are healthier and have normal kidney function," said Dr. Kitchlu.

What Patients and Health Care Providers Can Do

The study's findings are important for patients and clinicians alike, Susan Quaggin, MD, chief of nephrology and hypertension at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician, told Health.

"This paper raises the alarm that patients with kidney disease are at an increased risk not only of cancer incidence but mortality," said Dr. Quaggin, who was not involved in the recent study. "We really need to be aware of this as clinicians, and patients need to understand their risk of kidney disease and get tested if they're at risk."

Another concerning aspect is that people often do not even know they have kidney disease, so they may not understand their risk of developing other medical complications, said Dr. Quaggin.

Understanding Kidney Disease Risk Factors

Early CKD often has no recognizable signs or symptoms, so determining risk factors is often a key way for people to get diagnosed with the disease. According to the Centers for Disease Control and Prevention, you should talk to your doctor about getting tested for CKD if you have any of the following risk factors:

• Diabetes
• High blood pressure
• Family history of CKD
• Heart disease

The CDC also notes that African Americans, Hispanic/Latino Americans, and American Indians are at a higher risk for developing CKD, as are women.

If you're diagnosed with kidney disease early enough, there are many medications that can slow down the progression of kidney failure and, as a result, prevent associated complications, said Dr. Quaggin.

Mitigating Cancer Risk if You Have Kidney Disease

One of the ways to prevent the types of cancers associated with kidney disease is to prevent kidney disease altogether. While genetics can contribute to kidney disease, Dr. Kitchlu said lifestyle factors such as controlling blood pressure, maintaining healthy blood sugar levels, and preventing obesity can reduce the risk of developing kidney disease.

If you already have kidney disease, talk to your primary care provider about whether cancer screening is appropriate for you. "My hope is that with optimizing what's available at present in terms of cancer screening, patients will have cancers detected earlier, and will therefore be able to receive treatment earlier," said Dr. Kitchlu.

Along with encouraging the public to take kidney disease and its risks seriously, Dr. Kitchlu hopes the medical community will work toward earlier screening and better cancer treatment for kidney disease patients — for example, modifying existing cancer treatments to be safe for these patients and including these patients in clinical trials for up-and-coming cancer treatment.

"We as a community have to focus on ways to safely treat people who have other medications," said Dr. Kitchlu. "Because at present, the burden of kidney disease is increasing in the general population."