Abstract 4202: Kidney function and risk of renal cell carcinoma

Abstract Background: The relationship between kidney function and risk of renal cell carcinoma (RCC) is not well understood. In this study, we evaluated the association between estimated glomerular filtration rate (eGFR) and risk of incident RCC, and assessed whether this association depends on time between eGFR measurement and RCC diagnosis. We also sought to evaluate if eGFR may be useful to predict RCC risk. Methods: We conducted this study in the UK Biobank cohort based on 440,983 participants of whom 984 were diagnosed with RCC during 4,552,747 person-years of follow-up. The temporal relation between kidney function and RCC was evaluated with flexible parametric survival models for eGFR calculated from creatinine, cystatin C and both, adjusted for C-reactive protein (CRP) and common RCC risk factors. We also assessed the benefit of combining CRP and eGFR with a published RCC risk prediction model by estimating calibration and discrimination using a resampling algorithm as internal validation. Results: We found that a lower eGFR - an indication of poor kidney function - was associated with higher RCC risk when measured up to five years prior to diagnosis. We estimated the RCC hazard ratio per standard deviation decrease in eGFR when measured one year before diagnosis at 1.22 (95% confidence interval [95% CI]: 1.11-1.34), and at 1.14 (95% CI: 1.05-1.19) when measured five years before diagnosis. The corresponding RCC HR for eGFR measured ten years before diagnosis was 1.03 (95% CI: 0.95-1.12). Adding eGFR to the RCC risk model provided a small improvement in risk discrimination 2 years before diagnosis with a C-index of 0.76 (95% CI: 0.71-0.81) compared to the published model (0.73, 95% CI: 0.68-0.79). Conclusion: This study demonstrated that markers of kidney function are robustly associated with RCC risk when measured within the last five years leading up to diagnosis. However, kidney function markers do not seem to provide important improvements in RCC risk discrimination beyond established risk factors. Citation Format: Karine Alcala, Nicolas Alcala, Richard Martin, Paul Brennan, David Muller, Hilary A. Robbins, Mattias Johansson. Kidney function and risk of renal cell carcinoma. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4202.