[Early ultrasound detection of renal tumors in patients with end stage renal disease in dialysis].
OBJECTIVE
Patients with end stage renal disease in dialysis are a population susceptible to suffer various types of cancers, mainly in the kidney and urinary tract. These tissues suffer systemic carcinogenic effects, including all that result from chemical and immunological changes secondary to renal failure, from the treatment they receive and dialysis itself. In the present article we determine the clinical, epidemiological, and pathological characteristics of patients with chronic renal failure in dialysis who presented renal tumors during the evolution of their disease over the last ten years.


METHODS
We reviewed the medical charts of patients with chronic renal failure receiving dialysis in our institution who were diagnosed of renal tumors and received surgical treatment over the last 10 years. Patients with incomplete medical charts, HIV infection, and renal adult policystic disease were excluded from the study.


RESULTS
10 tumors were detected in a total of nine patients with a mean age of 45.22 years (range 41-65 years), six males and three females; regarding the mean time from the start of dialysis to de diagnosis of the tumor: 5 appeared the first year, 2 between 2 and 5 years, and 2 more than five years from the start of dialysis. The most frequent cause of chronic renal failure was high blood pressure, in 55.5% of the patients. 90% of the tumors were diagnosed incidentally during a control study, with ultrasound being the main diagnostic test (100%), a finding that was confirmed with MRI and CT scan in 60% and 30% of the patients respectively. The operative findings were: 8 solid masses, 1 mixed mass, and 1 cystic mass. Six patients underwent open surgery and 4 laparoscopic surgery. The most frequent pathologic diagnosis was clear cell carcinoma in 60% of the tumors.


CONCLUSIONS
In our study population, we found that performance of periodic ultrasound controls enabled us to achieve early diagnosis and treatment of tumors of the kidney in patients in dialysis. Over the last years laparoscopy has become the treatment of choice for renal tumors, even in patients with chronic renal failure in dialysis.
Bellido
José Antonio
JA
Servicio de Urología, Fundació Puigvert, Barcelona, España.
Palou
Juan
J
Hübner
Marta
M
Pascual
Mercé
M
Sagristá
Rosa
R
Martínez
Esther
E
Martínez
Joaquín
J
Rosales
Antonio
A
Villavicencio
Humberto
H
D000328:Adult; D000368:Aged; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D007680:Kidney Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D014463:Ultrasonography