Renal Adenocarcinoma and End Stage Kidney Disease

Abstract

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.

Prognosis and characteristics of renal cell carcinoma in hemodialysis patients: Bilateral occurrence does not influence cancer‐specific survival

“…Previous reports suggested that bilateral RCC occurred in 5–36% of HD patients and multifocal tumors occurred in 60–80% of HD patients 15,17–19 . In our present study, 18% of patients had bilateral RCC, whether synchronous (6%) or metachronous (12%), and 44% of those had multifocal RCC.…”

“…Previous reports suggested that bilateral RCC occurred in 5-36% of HD patients and multifocal tumors occurred in 60-80% of HD patients. 15,[17][18][19] In our present study, 18% of patients had bilateral RCC, whether synchronous (6%) or metachronous (12%), and 44% of those had multifocal RCC. There is a question whether both kidneys should be removed in patients with ESRD and with a tumor on one side only that has been diagnosed by computed tomography, especially during a scheduled kidney transplantation.…”

Uremic Acquired Renal Cystic Disease

“…Even in patients with renal cell carcinoma, only 14% reveal symptoms. The high incidence of renal cell carcinoma with no or few symptoms and the quite large number (17.6%) of metastatic renal cell carcinoma cases [52] justify the institution of a regular kidney screen ing program in dialysis patients, especially as reports of such metastatic forms are on the increase [22,52,[62][63][64][65][66], Screening of dialyzed kidneys would be aimed at ascer taining the presence or absence of acquired cysts and detecting the presence of renal cell carcinoma. During screening, it can be fairly well assumed that kidney size after more than 3 years of hemodialysis is a reflection of the severity of cystic change [2], Therefore, even though there may be no cysts visible by CT scan, if the density of the kidney is lower than that of normal renal parenchyma and its size is greater than that expected for the duration of dialysis, then it may contain numerous small, histolog ically distinguishable acquired cysts [38].…”

Acquired Cystic Kidney Disease and Renal Cell Carcinoma: A Review

“…There was a 3 to 1 male predominance, higher than in the general population but less than had been previously reported in ESRD (2 1,93). Bilateral RCC was documented in seven cases (36, 104,108,120,124).…”