Risk of renal cell carcinoma after kidney transplantation.
Between December 1968 and July 1995, 2372 renal transplant recipients were seen regularly in our outpatient clinic. 154 patients (6.5%) of these subsequently developed a malignant tumor. One of the most frequently observed malignancies was a renal cell carcinoma in the native kidneys, found in 12 patients (7.8%; i.e. 0.5% of the total population), two of them with analgesic nephropathy and one with adult polycystic kidney disease. So-called acquired cystic kidney disease of the native kidneys was found in 73% of the patients with renal cell carcinoma. In the patients with renal cell carcinoma the median age at transplantation was 43.9 (39-55) yr. The median time from onset of end-stage renal failure and from transplantation to the appearance of the tumor amounted to 117.3 (43-206) and 75.8 (5-164) months, respectively. Despite nephrectomy, four patients died of the cancer (6-57 months). As a consequence we suggest a regular sonographic screening of the native kidneys twice a year in all renal transplant patients. As in dialysis patients, the main risk factors for the development of renal cell carcinoma seem to be so-called acquired cystic disease of the native kidneys and the underlying renal disease, such as analgesic nephropathy, and obviously not the immunosuppressive regimen after transplantation.
Kliem
V
V
Nephrology Department, Hannover Medical School, Germany.
Kolditz
M
M
Behrend
M
M
Ehlerding
G
G
Pichlmayr
R
R
Koch
K M
KM
Brunkhorst
R
R
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000553:Ambulatory Care; D000700:Analgesics / Q000009:adverse effects; D002292:Carcinoma, Renal Cell / Q000453:epidemiology*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D005921:Glomerulonephritis / Q000453:epidemiology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000139:chemically induced / Q000453:epidemiology; D052177:Kidney Diseases, Cystic / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000453:epidemiology*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D007690:Polycystic Kidney Diseases / Q000453:epidemiology; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014463:Ultrasonography
D000700:Analgesics