The association between glomerulonephritis (GN) and cancer has been well known for decades. However, studies evaluating long-term de novo cancer development in patients with GN are limited. This study aimed to evaluate the incidence of cancer development among patients with renal biopsy-proven GN during post-biopsy follow-up and the differences in outcomes according to cancer occurrence. We conducted a retrospective cohort study of adult patients who underwent renal biopsy at Seoul National Bundang Hospital between 2003 and 2017. After excluding 778 patients with age < 18 years, cancer diagnosis before or within 6 months after renal biopsy, immunosuppressant therapy before renal biopsy, or pathologic diagnoses other than GN, 822 patients were included in the analysis. Data on baseline clinical characteristics, renal biopsy results, and types and doses of immunosuppressant agents were collected from electronic medical records. The incidence of cancer was censored on the date when the first cancer was diagnosed. We evaluated rates of mortality and end-stage renal disease (ESRD) development during follow-up. During a mean follow-up period of 58.9 ± 44.5 months, 45 subjects (5.5%) developed de novo cancer. A comparison of clinical characteristics between subjects who did and did not develop cancer revealed that cancer patients were older and had higher comorbidities and immunosuppressant use. Overall, patients with GN had an elevated standardized incidence ratio (SIR) of 7.16 (95% confidence interval (CI): 5.22–9.61) relative to the age- and sex-matched general population. In particular, the SIR was significantly higher in GNs such as membranous nephropathy (MN), IgA nephropathy, lupus nephritis, and focal segmental glomerulosclerosis. Multivariable Cox proportional hazard model revealed that patients with MN had an increased risk of cancer development, with a hazard ratio of 2.30 [95% CI: 1.06–4.98]. Patients with MN who developed cancer had a significantly higher risk of mortality (hazard ratio: 6.59; 95% CI: 1.22–35.56, P = 0.03) than those without cancer, but there was a non-significant difference in ESRD development. Conclusions: Patients with GN without concurrent cancer, particularly those with MN, have significantly higher risks of cancer development and subsequent mortality and should remain aware of the potential development of malignancy during follow-up.

中文翻译：

---

肾活检后肾小球肾炎患者的癌症发展和死亡率差异：单中心回顾性队列研究。

几十年来，肾小球肾炎 (GN) 与癌症之间的关联已广为人知。然而，评估 GN 患者长期新发癌症发展的研究是有限的。本研究旨在评估肾活检证实 GN 患者在活检后随访期间癌症发展的发生率以及根据癌症发生率的结果差异。我们对 2003 年至 2017 年间在首尔国立盆唐医院接受肾活检的成年患者进行了一项回顾性队列研究。在排除了 778 名年龄 < 18 岁、肾活检前或后 6 个月内诊断出癌症、肾活检前接受免疫抑制剂治疗的患者后，或 GN 以外的病理诊断，822 名患者被纳入分析。基线临床特征数据、肾活检结果、从电子病历中收集免疫抑制剂的类型和剂量。癌症的发病率在第一个癌症被诊断出的日期被审查。我们评估了随访期间的死亡率和终末期肾病 (ESRD) 发展率。在 58.9 ± 44.5 个月的平均随访期间，45 名受试者 (5.5%) 患上了新发癌症。比较患癌和未患癌症的受试者的临床特征表明，癌症患者年龄较大，合并症和免疫抑制剂使用率较高。总体而言，相对于年龄和性别匹配的一般人群，GN 患者的标准化发病率 (SIR) 升高了 7.16（95% 置信区间 (CI)：5.22-9.61）。特别是，肾病如膜性肾病 (MN) 的 SIR 显着更高，IgA 肾病、狼疮性肾炎和局灶节段性肾小球硬化。多变量 Cox 比例风险模型显示，MN 患者发生癌症的风险增加，风险比为 2.30 [95% CI：1.06–4.98]。患有癌症的 MN 患者的死亡风险显着高于未患癌症的患者（风险比：6.59；95% CI：1.22-35.56，P = 0.03），但 ESRD 的发展无显着差异。结论：没有并发癌症的 GN 患者，特别是那些有 MN 的患者，发生癌症和随后死亡的风险显着更高，并且应该在随访期间保持警惕恶性肿瘤的潜在发展。多变量 Cox 比例风险模型显示，MN 患者发生癌症的风险增加，风险比为 2.30 [95% CI：1.06–4.98]。患有癌症的 MN 患者的死亡风险显着高于未患癌症的患者（风险比：6.59；95% CI：1.22-35.56，P = 0.03），但 ESRD 的发展无显着差异。结论：没有并发癌症的 GN 患者，特别是那些有 MN 的患者，发生癌症和随后死亡的风险显着更高，并且应该在随访期间保持警惕恶性肿瘤的潜在发展。多变量 Cox 比例风险模型显示，MN 患者发生癌症的风险增加，风险比为 2.30 [95% CI：1.06–4.98]。患有癌症的 MN 患者的死亡风险显着高于未患癌症的患者（风险比：6.59；95% CI：1.22-35.56，P = 0.03），但 ESRD 的发展无显着差异。结论：没有并发癌症的 GN 患者，特别是那些有 MN 的患者，发生癌症和随后死亡的风险显着更高，并且应该在随访期间保持警惕恶性肿瘤的潜在发展。03) 比那些没有癌症的人，但在 ESRD 发展上没有显着差异。结论：没有并发癌症的 GN 患者，特别是那些有 MN 的患者，发生癌症和随后死亡的风险显着更高，并且应该在随访期间保持警惕恶性肿瘤的潜在发展。03) 比那些没有癌症的人，但在 ESRD 发展上没有显着差异。结论：没有并发癌症的 GN 患者，特别是那些有 MN 的患者，发生癌症和随后死亡的风险显着更高，并且应该在随访期间保持警惕恶性肿瘤的潜在发展。