Colorectal cancer is the fourth most common cancer in the UK, accounting for 12% of all cancer cases. Conditions that affect the kidneys ability to produce urine can be sudden or longstanding. Acute kidney injury is when kidney function worsens abruptly (within days). Chronic kidney disease (CKD) is a long-term condition where the kidneys do not work as well for more than 3 months. Kidney disease is common (approximately 6% of the UK population have CKD) and it is associated with increased risk of death (approximately 100,000 deaths in the UK are associated with acute kidney injury) and other diseases.
However, little is known about the relationship between colorectal cancer and the risk of kidney disease. Studies have shown that certain colorectal cancer treatments, such as surgery to remove tumours and chemotherapy drugs, increase the risk of developing kidney diseases. Additionally, both colorectal cancer and kidney disease commonly affect people who are older and already unwell, which could also party explain a link between these two diseases. In this project, we aim to help understand the relationship between colorectal cancer and kidney conditions by comparing kidney disease diagnoses in people who have had colorectal cancer, and people of the same age and sex who have not had cancer.
Colorectal cancer and kidney conditions (such as acute kidney injury [AKI] & chronic kidney disease [CKD]) are common in older people. There is currently little evidence on the relationship between colorectal cancer and kidney disease. It is thought that colorectal cancer treatments that could cause damage to the kidneys (such as ileostomies or nephrotoxic chemotherapy drugs) and/or shared risk factors could affect kidney function in those with colorectal cancer. It is important to understand the relationship between colorectal cancer and kidney conditions considering the high burden of morbidity, mortality and costs associated with the management of kidney conditions, the increasing survival rate of colorectal cancer and the aging population in the UK.
Our study will compare the baseline prevalence of kidney conditions in colorectal cancer patients to matched controls from the general population. We will then compare rates of incident kidney disease after colorectal cancer diagnoses between people with and without colorectal cancer. We will also assess whether the association between colorectal cancer and kidney disease changes with the number of years the individual has survived colorectal cancer or with other individual-level factors.
We will conduct a historical comparative matched cohort study where individuals over 18 with a diagnosis of colorectal cancer during the study period (earliest available HES data until the latest available CPRD data) will be individually matched, 1:5, with individuals registered with practices in CPRD with no history of any cancer. Hazard ratios will be calculated using Coxs proportional hazards models to compare the rates of kidney disease between individuals with colorectal cancer and the matched cohort.
Acute Kidney injury; Chronic kidney disease; End stage renal disease (ESRD)
Krishnan Bhaskaran - Chief Investigator - London School of Hygiene & Tropical Medicine ( LSHTM )
Kirsty Andresen - Corresponding Applicant - OXON Epidemiology - Spain
alycia perkins - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Dorothea Nitsch - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Helen Strongman - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Helena Carreira - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Kathryn Mansfield - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Laurie Tomlinson - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Tetyana Perchyk - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
2011 Rural-Urban Classification at LSOA level;HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation