title: Proteinuria as a risk factor for mortality in patients with colorectal cancer.
abstract: OBJECTIVE
  We investigated the effects of proteinuria and renal insufficiency on all-cause mortality in patients with colorectal cancer, with special emphasis on cancer staging and cancer-related deaths.
  
  
  METHODS
  We retrospectively studied a cohort of patients with colorectal cancer. In protocol 1, patients were classified into four groups based on the operability of cancer and proteinuria: group 1, early-stage cancer patients (colorectal cancer stage ≤ 3) without proteinuria; group 2, early-stage cancer patients with proteinuria; group 3, advanced-stage cancer patients without proteinuria (colorectal cancer stage=4); and group 4, advanced- stage cancer patients with proteinuria. In protocol 2, patients were classified into four similar groups based on cancer staging and renal insufficiency (eGFR <60 mL/min/1.73 m(2)). Between January 1, 1998 and December 31, 2009, 3379 patients were enrolled in this cohort and followed until May 1, 2012 or until death.
  
  
  RESULTS
  The number of patients with proteinuria was 495 (14.6%). The prevalence of proteinuria was higher in advanced-stage cancer (n=151, 22.3%) than in early-stage cancer patients (n=344, 12.7%). After adjusting for age, gender and other clinical variables, the proteinuric, early-stage cancer group was shown to be associated with an adjusted hazard ratio of 1.67 and a 95% confidence interval of 1.38-2.01, compared with non-proteinuric early-stage cancer patients. However, renal insufficiency was not associated with colorectal cancer mortality.
  
  
  CONCLUSIONS
  Proteinuria is an important risk factor for cancer mortality, especially in relatively early colorectal cancer.
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, 42 Jebong-ro, Gwangju 501-757, Korea.
authors.forename: Min Jee
authors.initials: MJ
authors.lastname: Kim
authors.forename: Yong Un
authors.initials: YU
authors.lastname: Kang
authors.forename: Chang Seong
authors.initials: CS
authors.lastname: Kim
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Choi
authors.forename: Eun Hui
authors.initials: EH
authors.lastname: Bae
authors.forename: Seong Kwon
authors.initials: SK
authors.lastname: Ma
authors.forename: Sun-Seog
authors.initials: SS
authors.lastname: Kweon
authors.forename: Soo Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D011507:Proteinuria / Q000150:complications* / Q000453:epidemiology; D051437:Renal Insufficiency / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Cancer; GFR; death; proteinuria; stage
references.citation: Diabetes. 2002 Apr;51(4):1157-65
references.pmid: 11916939
references.citation: Am J Med. 1974 Oct;57(4):536-41
references.pmid: 4611206
references.citation: J Natl Compr Canc Netw. 2009 Sep;7(8):778-831
references.pmid: 19755046
references.citation: Diabetes Care. 2002 Jan;25(1):43-8
references.pmid: 11772899
references.citation: Leuk Lymphoma. 2004 Mar;45(3):547-51
references.pmid: 15160917
references.citation: Br J Haematol. 2003 Apr;121(2):275-9
references.pmid: 12694249
references.citation: J Am Soc Nephrol. 2005 Dec;16(12):3728-35
references.pmid: 16251239
references.citation: Nephron. 1985;40(3):303-8
references.pmid: 4010844
references.citation: Cancer Epidemiol Biomarkers Prev. 2010 Nov;19(11):2950-7
references.pmid: 20855537
references.citation: Acta Oncol. 2000;39(2):145-9
references.pmid: 10859003
references.citation: Br J Haematol. 1999 Dec;107(4):889-91
references.pmid: 10606899
references.citation: Transplant Rev (Orlando). 2012 Jan;26(1):3-13
references.pmid: 22137726
references.citation: Lancet Oncol. 2007 Jul;8(7):572-3
references.pmid: 17613421
references.citation: Med Oncol. 2000 May;17(2):117-22
references.pmid: 10871817
references.citation: Clin J Am Soc Nephrol. 2011 May;6(5):1121-8
references.pmid: 21511834
references.citation: Ann Intern Med. 1990 Nov 15;113(10):779-88
references.pmid: 2240880
references.citation: Cancer Res. 1976 Jan;36(1):43-7
references.pmid: 764968
references.citation: J Clin Lab Anal. 2012 Feb;26(2):82-92
references.pmid: 22467323
references.citation: Scand J Clin Lab Invest. 2005;65(6):477-84
references.pmid: 16179280
references.citation: Ann Intern Med. 2006 Aug 15;145(4):247-54
references.pmid: 16908915
references.citation: Eur J Cancer. 1998 Jan;34(1):206-7
references.pmid: 9624263
references.citation: Int Surg. 1995 Jan-Mar;80(1):49-52
references.pmid: 7657492
references.citation: J Urol. 2003 Oct;170(4 Pt 1):1135-7
references.pmid: 14501709
references.citation: Cancer Res Treat. 2012 Mar;44(1):25-31
references.pmid: 22500157
references.citation: Am J Epidemiol. 2003 Jun 15;157(12):1092-100
references.pmid: 12796045
references.citation: Am J Nephrol. 2011;33(2):121-30
references.pmid: 21242672
references.citation: Eur J Cancer. 1998 Jan;34(1):76-80
references.pmid: 9624241
references.citation: Nephrol Dial Transplant. 1989;4(11):947-50
references.pmid: 2516885
references.citation: Acta Oncol. 1996;35(6):691-5
references.pmid: 8938215
references.citation: Am J Hypertens. 2004 Oct;17(10):986-93
references.pmid: 15485765
references.citation: Br Med J (Clin Res Ed). 1988 May 7;296(6632):1295-8
references.pmid: 3133055