title: Association between chronic kidney disease and cancer mortality: A report from the ALLHAT.
abstract: OBJECTIVE
  Chronic kidney disease (CKD) and cancer are both common in older patients; whether CKD increases risk for cancer is unclear. This study evaluated CKD as a risk factor for cancer mortality in a large cohort of hypertensive patients.
  
  
  METHODS
  We did post-hoc analyses of in-trial and post-trial data from participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).
  
  
  METHODS
  Participants were ≥ 55 years old with hypertension and one other additional risk factor for coronary heart disease.
  
  
  METHODS
  Baseline estimated glomerular filtration rate (eGFR).
  
  
  RESULTS
  Cancer mortality was ascertained by cancer-related deaths reported in national databases during and after the trial. Cox proportional hazard models were used to calculate hazard ratios (HRs) adjusted for possible confounders and were stratified by baseline GFR.
  
  
  RESULTS
  Participants' mean age was 66.9 years. After a mean follow-up of 8.9 years, there were 2,338 reported cancer-related deaths. Participants with GFR < 45 mL/min/1.73 m2were at increased risk of cancer mortality compared to those with GFR ≥ 90 mL/min/1.73 m2(adjusted HR 1.54 (1.22 - 1.94), p-value for trend 0.004). These findings were consistent across subgroups defined by race, gender, and diabetes. Participants with GFR < 45 mL/min/1.73 m2were at higher risk for mortality related to colon cancer (p-value for trend 0.048, HR 2.28 (1.12 - 4.62)) and urinary tract cancer (p-value for trend 0.001, adjusted HR 2.95 (1.14 - 7.65)).
  
  
  CONCLUSIONS
  This is a post hoc analysis of clinical trial data.
  
  
  CONCLUSIONS
  In a large cohort of hypertensive patients, GFR < 45 mL/min/1.73 m2was associated with a higher risk of cancer-related mortality.
authors.forename: Dhruti P
authors.initials: DP
authors.lastname: Chen
authors.forename: Barry R
authors.initials: BR
authors.lastname: Davis
authors.forename: Lara M
authors.initials: LM
authors.lastname: Simpson
authors.forename: William C
authors.initials: WC
authors.lastname: Cushman
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cutler
authors.forename: Mirela
authors.initials: M
authors.lastname: Dobre
authors.forename: Charles E
authors.initials: CE
authors.lastname: Ford
authors.forename: Gail T
authors.initials: GT
authors.lastname: Louis
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Suzanne
authors.initials: S
authors.lastname: Oparil
authors.forename: Linda B
authors.initials: LB
authors.lastname: Piller
authors.forename: Sara L
authors.initials: SL
authors.lastname: Pressel
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sarnak
authors.forename: Paul K
authors.initials: PK
authors.lastname: Whelton
authors.forename: Jackson T
authors.initials: JT
authors.lastname: Wright
authors.forename: Mahboob
authors.initials: M
authors.lastname: Rahman
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology*; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents