Higher risk of malignant neoplasms in young adults with end‐stage renal disease receiving haemodialysis: A nationwide population‐based study

Abstract

AimPrevious investigations have shown that end‐stage renal disease (ESRD) is associated with an increased risk of malignancies. The aim of this study was to explore the association between ESRD in patients undergoing maintenance haemodialysis (HD) and the incidence of malignancies according to age.MethodsWe analysed a nationwide cohort retrieved from Taiwan's National Health Insurance Research Database to study the incidence of malignancies in patients who were and were not receiving HD. One million beneficiaries were randomly selected and followed from 2005 to 2013. Of these 1 000 000 patients, 3055 developed ESRD and commenced maintenance HD during this period. For each HD patient, four age‐, gender‐ and diabetes‐matched controls were selected from the database (n = 12 220). We further stratified the patients according to age. The study endpoint was the occurrence of malignancy.ResultsThe incidence rates of malignancy were 6.8% and 4.9% in the HD and control groups, respectively. Competing risk regression analysis indicated that age, HD, male gender and diabetes were associated with an increased risk of malignancy. When further stratified according to age, the odds ratios of developing cancer were 5.8, 1.9, 1.9 and 1.5 among the HD patients aged <40 years, 40–49 years, 50–59 years and 60–69 years, respectively.ConclusionThe patients with ESRD who received HD had a significantly higher cumulative risk of malignancy, especially those with a young age. Therefore, specialized cancer screening protocols for young HD patients might help to prolong their lifespan.

Desenvolvimento de neoplasias em pacientes em diálise: revisão de literatura

“…Em relação ao desenvolvimento de câncer em pacientes em diálise percebeu-se que existe uma variedade nas diferentes manifestações de DRC levando em consideração, também, as diferentes regiões de realização dos estudos. Nessa perspectiva de análise, Pan et al (2019) em um estudo de base populacional em Taiwan identificou uma diferença de 1,9% a mais de malignidade nos pacientes em hemodiálise em comparação com o grupo controle. Foram encontradas diferentes neoplasias, como sarcoma de Kaposi, neoplasias nos órgãos geniturinários, tecido linfático, hematopoiético e de fígado.…”

“…Esses pacientes também desenvolvem carências de metabólitos e vitaminas básicas. Tudo isso contribui para que eles tenham sua imunidade humoral e mediada por células diminuídas o deixando mais suscetíveis a cânceres mediados por vírus, como o papilomavírus humano e o vírus da hepatite (PAN et al, 2019).…”

Adult Kidney Cancer in the Thies Region: Epidemiological, Diagnostic and Therapeutic Aspects

“…In primary prevention for kidney cancer, smoking cessation, physical activity and weight loss would be recommended Volume 08; Issue 12 J Urol Ren Dis, an open access journal ISSN: 2575-7903 [11]. The risk of developing kidney cancer increases with the duration of dialysis [12].…”

Renal Cell Carcinoma: A Complex Therapeutic Challenge in the Elderly

“…Similarly, the overall relative risk of RCC is 5-10-times higher in patients with end-stage renal failure [ 24 ]. In accordance with the use of HD, a comparative survey revealed the incidence of genitourinary cancer in patients who underwent HD versus the control group with a significant difference of 1.6% to 0.8%, respectively, emphasizing the pathological burden of the intervention to acquire the malignancy at a higher pace and conclude a steady relationship of hemodialysis toward the development of ultimate RCC [ 26 ].…”

“…Despite the rarity of renal cell tumors in adolescents, the preferred treatment of mainstay overall appears to involve surgical excision. However, a failure of the latter option or an underlying end-stage renal disease (ESRD) may result in the ultimate progression towards HD where the management of patients from all age groups appears as a challenging confrontation, with older HD patients being specifically vulnerable to die from other complications before even developing the malignancy [ 26 - 27 ]. An interesting study by Pan HC et al concludes a higher risk of young with HD to develop cancer in comparison to the geriatric age group highlighting the mandatory need for an overall intensive and efficacious cancer screening protocol [ 24 , 26 ].…”