Kidney Health With Androgen-Deprivation Therapy for Prostate Cancer
Posted: Monday, May 17, 2021
The known adverse effects of androgen-deprivation therapy given to treat prostate cancer, directly resulting from marked reductions in testosterone, include a greater risk of fractures, diabetes, and cardiovascular disease. The hypothesis of another link—between hormone therapy and risk of acute kidney injury—was addressed recently in Prostate Cancer and Prostatic Diseases. For the most part, no connection emerged.
Úna C. McMenamin, PhD, of Queen’s University Belfast, Northern Ireland, and colleagues analyzed data regarding 10,751 men who were newly diagnosed with prostate cancer between 2012 and 2017 in Scotland and a matched prostate cancer–free cohort. Based on hospitalization records through June 2019, they found that men with prostate cancer actively using hormone therapy had no significant increase in acute kidney injury than men with prostate cancer not using hormone therapy after adjusting for potential confounders.
“This should provide some reassurance to clinicians prescribing, and patients taking, androgen-deprivation therapy,” the team wrote. Although the use of one specific agent—the gonadotropin-releasing hormone antagonist degarelix—was associated (for the first time in the literature) with an observed increased risk of acute kidney injury, with a fully adjusted hazard ratio of 2.47, Dr. McMenamin and co-investigators found that result “difficult to interpret, [because] it was…based upon relatively few acute kidney injury events and degarelix users are likely to have more advanced prostate cancer.” The finding merits further research, noted the team.
Patients with prostate cancer, in general, were found to have higher rates of acute kidney injury than cancer-free controls, with an adjusted hazard ratio of 1.47, reported the researchers. The cohort with prostate cancer was followed for 41,997 person years, during which there were 618 hospitalizations for acute kidney injury.
Disclosure: The study authors reported no conflicts of interest.
