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The aggressiveness of urinary tract urothelial carcinoma increases with the severity of chronic kidney disease

  1. Peir-Haur Hung1,
  2. Cheng-Huang Shen1,
  3. Yen-Ling Chiu2,
  4. Ing-Ching Jong1,
  5. Pei-Chun Chiang1,
  6. Chang-Te Lin1,
  7. Kuan-Yu Hung3,*,
  8. Tun-Jun Tsai3

Article first published online: 22 JUN 2009

DOI: 10.1111/j.1464-410X.2009.08636.x

Issue

BJU International

BJU International

Volume 104, Issue 10, pages 1471–1474, November 2009

Additional Information

How to Cite

Hung, P.-H., Shen, C.-H., Chiu, Y.-L., Jong, I.-C., Chiang, P.-C., Lin, C.-T., Hung, K.-Y. and Tsai, T.-J. (2009), The aggressiveness of urinary tract urothelial carcinoma increases with the severity of chronic kidney disease. BJU International, 104: 1471–1474. doi: 10.1111/j.1464-410X.2009.08636.x

Author Information

  1. 1

    Departments of Internal Medicine and Urology, Chia-yi Christian Hospital, Chia-yi,

  2. 2

    Department of Internal Medicine, Far Eastern Memorial Hospital and

  3. 3

    Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

*Kuan-Yu Hung, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, Taiwan. e-mail: kyhung@ntu.edu.tw

Publication History

  1. Issue published online: 20 OCT 2009
  2. Article first published online: 22 JUN 2009
  3. Accepted for publication 13 March 2009

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Keywords:

  • urothelial carcinoma;
  • chronic kidney disease;
  • end-stage renal disease;
  • survival

OBJECTIVE

To assess, in a retrospective cohort, urinary tract urothelial carcinoma (UT-UC) in patients with various stages of chronic kidney disease (CKD) and their clinicopathological features, as patients with end-stage renal disease (ESRD) have a higher incidence of UT-UC, but the relationship between early stages of CKD and characteristics of UT-UC are less well known.

PATIENTS AND METHODS

The study included 267 patients with pathologically confirmed UT-UC from January 1994 to December 2006; all had a physical examination (blood pressure), and measurements of laboratory data (serum creatinine, serum haemoglobin) and pathological data. The glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease equation. Patients were divided into three groups by individual GFR (mL/min), i.e. >60 (no/mild CKD), 30–60 (CKD stage 3) and <30 (CKD stage 4/5).

RESULTS

The CKD stages included 81 (30.3%) patients with none/mild CKD, 121 (45.3%) with CKD stage 3 and 65 (24.3%) with CKD stage 4/5. There was a significant and parallel increase in the frequency of UT-UC as CKD severity increased from none/mild CKD to stage 3 (11% vs 55%), and from CKD stage 3 to 4/5 (55% vs 71%; P < 0.05). Pathologically, the frequency of high-grade and high T stage UT-UC in patients with CKD stage 3 (90% and 35%, respectively) and CKD stage 4/5 (91% and 29%, respectively) were significantly greater than in the group with none/mild CKD (P < 0.001). Advanced age and more distant metastasis were independent risk factors for patient survival.

CONCLUSION

The aggressiveness of UT-UC increased with the severity of CKD, and this might have important clinical consequences.

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