title: Spironolactone and the risk of urinary tract cancer in patients with hypertension: a nationwide population-based retrospective case-control study.
abstract: This was a nationwide study by National Health Insurance Research Database to investigate the risk of urinary tract cancers (UTCs) for renin-angiotensin-aldosterone system inhibitors including spironolactone.
  
  
  
  A total of 32 167 UTC patients with hypertension were enrolled in the National Health Insurance program between 2005 and 2011.
  
  
  
  Among different subclasses of renin-angiotensin-aldosterone system inhibitors, the adjusted odds ratio (OR) for UTC risk was 1.00 [95% confidence interval (CI) = 0.96-1.04] in angiotensin-converting enzyme inhibitors, 1.22 (95% CI = 1.18-1.26) in patients who received angiotensin II receptor blockers, 0.91 (95% CI = 0.87-0.96) in spironolactone. Spironolactone is associated with a significantly lower risk of prostate cancer (adjusted OR = 0.88, 95% CI = 0.82-0.94) in the male patients. A similar trend was observed in the female patients for the risk of bladder cancer (adjusted OR = 0.81, 95% CI = 0.72-0.92).
  
  
  
  Our findings show that a lower risk of UTCs significantly associated with spironolactone in patients.
authors.affiliation: aDivision of Nephrology, Taichung Veterans General Hospital, TaichungbDepartment of Pediatric Nephrology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, TaoyuancDivision of Urology, Taichung Veterans General HospitaldManagement Office for Health Data, China Medical University HospitaleCollege of Medicine, China Medical UniversityfGraduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical UniversitygDepartment of Nuclear Medicine and PET Center, China Medical University HospitalhDepartment of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Chuang
authors.forename: Mei-Ching
authors.initials: MC
authors.lastname: Yu
authors.forename: Shih-Ting
authors.initials: ST
authors.lastname: Huang
authors.forename: Cheng-Kuang
authors.initials: CK
authors.lastname: Yang
authors.forename: Cheng-Hsu
authors.initials: CH
authors.lastname: Chen
authors.forename: Ying-Chih
authors.initials: YC
authors.lastname: Lo
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Kuo-Hsiung
authors.initials: KH
authors.lastname: Shu
authors.forename: Tung-Min
authors.initials: TM
authors.lastname: Yu
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D065840:Protective Factors; D012189:Retrospective Studies; D013148:Spironolactone / Q000627:therapeutic use*; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology*
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone