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Purpose: End-stage renal disease (ESRD) is a known risk factor for the development of renal cell carcinoma (RCC). This case-control study was performed to assess the risk in a nationwide cohort and evaluate tumor characteristics and survival in the ESRD-RCC population. Methods: In this study, 9,299 patients with RCC identified in the National Swedish Kidney Cancer Register from 2005 until 2014 and 93,895 matched controls were linked to the Swedish Renal Registry and the National Patient Register. ESRD was defined as chronic kidney disease stage 5, kidney transplantation or kidney dialysis 0-40 years before the diagnosis of RCC. Results: A total of 117 patients with ESRD and subsequent RCC were identified and compared with 9,087 patients with RCC. There was a 4.5-times increased risk for RCC among ESRD patients (95% CI ¼ 3.6-5.6; p < 0.001) compared to matched controls. Longer time with ESRD increased the risk of RCC (ESRD > 9 years, OR ¼ 10.2, 95% CI ¼ 7.0-14.8). The ESRD-RCC patients were younger (p ¼ 0.002), had smaller tumors (p < 0.001) and had lower tumor stage (p ¼ 0.045). The incidence of papillary and chromophobe RCC was higher and clear cell RCC lower among the ESRD patients (p < 0.001). The 5-year overall survival was 50% in ESRD-RCC patients and 63% in RCC-only patients (p < 0.05). Conclusion: More than 9 years with ESRD increased the risk of developing RCC 10-times compared to individuals without ESRD and the tumors showed a different histopathological pattern. Despite a less advanced tumor stage at diagnosis, the overall survival in ESRD-RCC patients was lower compared to patients with RCC-only.

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Operating in the least regulated telecommunications market in Europe, Swedish Telia is exposed to rigorous competition from intemational telecom companies. More efficient energy use is an excellent way of reducing costs over the long term and thereby boosting our competitiveness. Over the last three years, Telia has carried out an intensive cost-cutting exercise in the area of energy supply for telecommunication processes.The development of the telecom network, both in terms of design and construction, has long been accompanied by the extensive standardisation of products and procedures. The use of modular design, moreover, has resulted in systems which are highly flexible. These factors, combined with effective management and close operational control, have helped pave the way for Telia's successful development in the telecommunications field. Unfortunately, however, these approaches have not been applied to the same degree and with the same consistency on the energy side. Energy supply plant and, above all, cooling systems have been designed and built to meet the needs of existing exchange buildings -rather than the other way round -and with little regard for standardisation or closer integration with the telecom process as a whole. This failure to achieve an overall view has led to the high costs we are now seeking to remedy.The objectives set out for Tele Energy 2000 included a 15% reduction in annual costs for the Network Services Division after three years. A before-and-after cost comparison for the three-year period was to be made using figures derived from the cost-budget model presented in Washington 1992. An examination of costs three years on shows that we have not fully succeeded in achieving that objective. But we are on the way, according to our latest measurements of the cost development. Due to organisational and other complications, implementation of the project proved a great deal more difficult than we had initially anticipated. IntroductionIn Europe, Sweden is the country offering the most open telecom market, which puts Telia in a very tough competitive situation. More efficient consumption of energy is a good way of lowering the costs for many years to come and thus a means to make us more competitive. For three years now, Telia has carried out an intensive cost saving program aimed at energy consumption in the telecom process. People in different positions had observed that investment, operation and maintenance costs of energy were very high compared with the costs related to telecom technology. Other observations made in the regions were that telecom buildings were oversized and a project, the to review all dimensioning rules. The Power Supply section at Byggdim project (BuildDimensioning project), was started in order Headquarters prepared an energy-saving project, Energieffektivisering 2000 (Efficient energy consumption 2000) or EE 2000, including a model of an expense budget for telecom energy. This telecom energy cost model would serve as a control device in the process of controlling ...