Seven cases of renal cell carcinoma in hemodialysis patients.

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Abdominal ultrasonography was conducted on 610 hemodialysis patients from March 1983 to December 1988. The relationship between renal cell carcinoma and ACDK (acquired cystic disease of the kidney) was studied. Comparisons were also made of renal cell carcinoma in hemodialysis patients and non-hemodialysis patients. Renal cell carcinoma was found in 7 patients (1.15%). The rate of discovery was 19 times higher than in nonhemodialysis patients. In all patients, the resected tumors were small renal cell carcinomas of less than 3.7cm in diameter, which fell into early cancer of stage I by Rebson's classification. In 7 patients, ultrasonography revealed a mass that had an internal echo with clear boundary and could be readily differentiated from cyst, angiomyolipoma and hematoma. There was no difference between hemodialysis and non-hemodialysis patients regarding ultrasonographic findings, stage, growth and histological classification. Of these 7 patients, ACDK was found in 6. In view of the finding that the tumor was inside the cyst and that it was associated with chronic glomerulonephritis, which was likely to develop into ACDK, ACDK seemed to be one of the factors leading to renal cell carcinoma in hemodialysis patients. Therefore, abdominal ultrasonography is most suitable for screening for renal cell carcinoma and should be carried out at least once a year for early discovery.
社団法人日本透析医学会の論文