title: Upper tract urothelial carcinomas in patients with chronic kidney disease: relationship with diagnostic challenge.
abstract: Chronic kidney disease and upper tract urothelial carcinomas display a bidirectional relationship. Review of the literature indicates that early diagnosis and correct localization of upper tract urothelial carcinomas in dialysis patients and kidney transplant recipients are important but problematic. Urine cytology and cystoscopy have limited sensitivity for the diagnosis of upper tract urothelial carcinomas in dialysis patients. Enhanced computed tomography and magnetic resonance imaging could prove useful for the detection and staging of upper tract urothelial carcinomas in dialysis patients. Renal ultrasound can detect hydronephrosis caused by upper tract urothelial carcinomas in kidney transplant recipients but cannot visualize the carcinomas themselves. High detection rates for upper tract urothelial carcinomas in kidney transplant recipients have recently been demonstrated using computed tomography urography, which appears to be a promising tool. To detect carcinomas in dialysis patients and kidney transplant recipients as early as possible, regular screening in asymptomatic patients and diagnostic work-up in symptomatic patients should be performed using a combination of urological and imaging methods. Careful assessment of subsequent recurrence within the contralateral upper urinary tract and the urinary bladder is necessary for dialysis patients and kidney transplant recipients with upper tract urothelial carcinomas.
authors.affiliation: Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, 5 Fu-Hsing Street, Gueishan, Taoyuan 33333, Taiwan ; Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan ; Institute of Radiological Research, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan.
authors.forename: Li-Jen
authors.identifier: 0000-0002-2263-4835
authors.initials: LJ
authors.lastname: Wang
authors.affiliation: Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan ; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan.
authors.forename: Shen-Yang
authors.initials: SY
authors.lastname: Lee
authors.affiliation: National Cancer Center and Duke-NUS Graduate Medical School, Singapore 169610.
authors.forename: Bin Tean
authors.initials: BT
authors.lastname: Teh
authors.affiliation: Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan ; Department of Urology of Linkou Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan.
authors.forename: Cheng-Keng
authors.initials: CK
authors.lastname: Chuang
authors.affiliation: Department of Nephrology, Erasme Hospital, 1070 Brussels, Belgium.
authors.forename: Joëlle
authors.initials: J
authors.lastname: Nortier
mesh_terms: D002277:Carcinoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014567:Urography; D014571:Urologic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology