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The association of end stage kidney disease with cystic degeneration and renal adenocarcinoma was first recognized in 1977. Since then a number of reports have confirmed this relationship. Duration of dialysis has been the most strongly associated risk factor. We report 8 cases of end stage kidney disease and renal adenocarcinoma. Median duration of hemodialysis was approximately 1 year, and 3 patients never had hemodialysis. Factors other than duration of dialysis, such as toxic metabolites, toxins from dialysis tubing, polyamines or other carcinogens, may be as or more important.

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