A novel risk factor for malignancy: Albuminuria

Eur J Intern Med. 2023 Dec:118:22-31. doi: 10.1016/j.ejim.2023.09.010. Epub 2023 Sep 22.

Abstract

Cancer is the second leading cause of death among the adult population following cardiovascular diseases. Prevention and earlier diagnosis are among the cornerstones in the management of malignancies. Albuminuria is a diagnostic criterion for chronic kidney disease and has been associated with multiple conditions including cardiovascular diseases and systemic inflammation while the association between albuminuria and malignancy has been inadequately addressed. Large-scale observational studies with long follow-up periods demonstrate a statistically significant association between albuminuria and overall malignancy incidence, especially urothelial malignancy incidence. However, the underlying pathophysiology linking these two entities is not a straightforward causal relationship but most likely a multidirectional relationship including a causal link. In this narrative review, we evaluate the clinical studies investigating the association between albuminuria and malignancy along with potential underlying mechanisms linking them. We also summarize data on the impact of treatment modalities prescribed for albuminuria and/or proteinuria on the prevention or prognosis of malignancies.

Keywords: Albuminuria; Glucagon-like peptide-1 receptor; Neoplasms; Proteinuria; Renin-angiotensin system; Sodium-glucose cotransporter-2 inhibitors.

Publication types

  • Review

MeSH terms

  • Adult
  • Albuminuria
  • Cardiovascular Diseases* / complications
  • Cardiovascular Diseases* / etiology
  • Diabetes Mellitus, Type 2* / complications
  • Humans
  • Neoplasms* / complications
  • Neoplasms* / epidemiology
  • Proteinuria / complications
  • Proteinuria / drug therapy
  • Risk Factors