Research Papers:

Patients with urothelial carcinoma have poor renal outcome regardless of whether they receive nephrouretectomy

Peir-Haur Hung, Hung-Bin Tsai, Kuan-Yu Hung, Chih-Hsin Muo, Mu-Chi Chung, Chao-Hsiang Chang and Chi-Jung Chung _

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Oncotarget. 2016; 7:61679-61689. https://doi.org/10.18632/oncotarget.11223

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Peir-Haur Hung1,2, Hung-Bin Tsai3, Kuan-Yu Hung4, Chih-Hsin Muo5, Mu-Chi Chung6, Chao-Hsiang Chang7, Chi-Jung Chung8,9

1Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan

2Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan

3Department of Tramatology, National Taiwan University Hospital, Taipei, Taiwan

4Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu City, Taiwan

5Management Office for Health Data, China Medical University and Hospital, Taichung, Taiwan

6Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan

7Department of Urology, China Medical University and Hospital, Taichung, Taiwan

8Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan

9Department of Medical Research, China Medical University Hospital, Taichung, Taiwan

Correspondence to:

Chi-Jung Chung, email: [email protected]

Keywords: chronic kidney disease, end stage renal disease, nephrouretectomy, urothelial carcinoma

Received: March 04, 2016    Accepted: July 27, 2016    Published: August 11, 2016


The association between urothelial carcinoma (UC) and subsequent ESRD incidence has not been confirmed. This was a population-based study using claims data from the Taiwan National Health Institutes from 1998 to 2010. The study cohort consisted of 26,017 patients with newly diagnosed UC and no history of ESRD, and the comparison cohort consisted of 208,136 matched enrollees without UC. The incidence of ESRD was ascertained through cross-referencing with a registry for catastrophic illnesses. Cox proportional hazard regression analysis was used to estimate the risk of ESRD associated with UC and UC subtype. A total of 979 patients (3.76%) from the UC group and 1,829 (0.88%) from the comparison group developed ESRD. Multivariable analysis indicated that compared with the comparison group, the hazard ratios (HRs) for ESRD were 7.75 (95% confidence interval [CI]: 6.84 to 8.78) and 3.12 (95% CI: 6.84 to 8.78) in the cohort with upper urinary tract UC (UT-UC) and bladder UC (B-UC), respectively. In addition, there were significantly increased risks for ESRD in UC patients receiving and not receiving nephrouretectomies or aristolochic acids (AA). Moreover, the UC patients receiving segmental ureterectomy and ureteral reimplantation had approximately 1.3-fold and 2.4-fold increased risk for ESRD after control for confounders, respectively. Thus, our data indicate that UT-UC and B-UC independently increased the risk for ESRD in patients after considering about nephrouretectomies or aristolochic acids (AA). In addition, UC patients receiving segmental ureterectomy and ureteral reimplantation had increased risk for ESRD.

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