Effect of RAAS Inhibition on the Incidence of Cancer and Cancer Mortality in Patients with Glomerulonephritis.
10.3346/jkms.2011.26.1.59
- Author:
Ho Jun CHIN
1
;
Se Won OH
;
Ho Suk GOO
;
Jieun OH
;
Jung Woo NOH
;
Jong Tae CHO
;
Ki Young NA
;
Suhnggwon KIM
;
Dong Wan CHAE
Author Information
1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. mednep@snubh.org
- Publication Type:Original Article
- Keywords:
Glomerulonephritis;
Neoplasms;
Angiotensin II Type 1 Receptor Blockers
- MeSH:
Adult;
Aged;
Angiotensin II Type 1 Receptor Blockers/*therapeutic use;
Angiotensin-Converting Enzyme Inhibitors/*therapeutic use;
Female;
Follow-Up Studies;
Glomerulonephritis/complications/diagnosis/*drug therapy;
Humans;
Incidence;
Kidney/pathology;
Male;
Middle Aged;
Neoplasms/complications/*epidemiology/mortality;
Renin-Angiotensin System/*drug effects;
Retrospective Studies;
Risk Factors
- From:Journal of Korean Medical Science
2011;26(1):59-66
- CountryRepublic of Korea
- Language:English
-
Abstract:
Angiotensin II type 1 receptor blocker (ARB), which is frequently prescribed in patients with glomerulonephritis (GN), is suggested to increase the risk of cancer. We registered 3,288 patients with renal biopsy and analyzed the relationship between the use of renin-angiotensin-aldosterone system (RAAS) blockade and the incidence of cancer or cancer mortality. After renal biopsy, cancer developed in 33 patients with an incidence rate of 1.0% (95% of CI for incidence: 0.7%-1.3%). There was no difference in the cancer incidence among the groups according to the use of angiotensin-converting enzyme inhibitors (ACEI) or ARB: 1.2% in the None (23/1960), 0.7% in the ARB-only (5/748), 0.4% in the ACEI-only (1/247), and 1.2% in the ACEI-ARB (4/333) (P = 0.487) groups. The cancer mortality was 2.1%, 0.4%, 0.0%, and 0.3% in None, ACEI-only, ARB-only, and ACEI-ARB group, respectively (P < 0.001). The risk of cancer mortality in patients with ARB was only 0.124 (0.034-0.445) compared to that of non-users of ARB by Cox's hazard proportional analysis. In conclusion, prescription of ACEI or ARB in patients with GN does not increase cancer incidence and recipients of ARB show rather lower rates of all-cause mortality and cancer mortality.
