title: Dialysis-requiring acute kidney injury increases risk of long-term malignancy: a population-based study.
abstract: BACKGROUND
  Acute kidney injury (AKI) is gaining worldwide attention recently, emerging as a major public health threat. However, the association between the development of AKI and subsequent malignancy has not been studied before.
  
  
  METHODS
  We conducted a population study based on the Taiwan National Health Insurance database, using 1,000,000 representative database during 2000-2008. All patients' survival to discharge from index hospitalization with recovery from dialysis-requiring AKI were identified (recovery group), and matched with those without recovery and those without AKI, at a 1:1:1 ratio.
  
  
  RESULTS
  We identified 625 individuals more than 18 years old [352 male (56.5%); mean age, 63.3 years] in recovery group and matched 625 individuals in each group. During a mean followed-up of 3.7 years, the incidences of new-onset malignancy were 4.2, 2.9, and 2.6 per 100 person-year among the non-recovery, the recovery, and the non-AKI group, respectively. After adjustment, the recovery group was more likely to develop long-term de novo malignancy than those without AKI [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.02-2.03; p = 0.04], while less likely than those who did not recover (HR 0.66, 95% CI 0.45-0.98; p = 0.04).
  
  
  CONCLUSIONS
  Dialysis-requiring AKI can post a long-term risk of de novo malignancy for those who survive from the initial insult. Even patients who have recovered from dialysis still carry a significantly higher possibility of developing malignancy than those without AKI episode.
authors: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei, 100, Taiwan.
authors: Chia-Ter
authors: CT
authors: Chao
authors: Cheng-Yi
authors: CY
authors: Wang
authors: Chun-Fu
authors: CF
authors: Lai
authors: Tao-Min
authors: TM
authors: Huang
authors: Yen-Yuan
authors: YY
authors: Chen
authors: Tze-Wah
authors: TW
authors: Kao
authors: Tzong-Shinn
authors: TS
authors: Chu
authors: Chia-Hsui
authors: CH
authors: Chang
authors: Vin-Cent
authors: VC
authors: Wu
authors: Wen-Je
authors: WJ
authors: Ko
authors: Likwang
authors: L
authors: Chen
authors: Kwan-Dun
authors: KD
authors: Wu
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000628:therapy*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology