title: High prevalence of colon adenomas in end-stage kidney disease patients on hemodialysis undergoing renal transplant evaluation.
abstract: The aim of this study was to determine whether patients with end-stage kidney disease (ESKD) on hemodialysis (HD) undergoing kidney transplant evaluation are at higher risk for colonic neoplasia than the general population. This is a retrospective cohort study of patients with ESKD who underwent a first screening colonoscopy while undergoing kidney transplant evaluation. Data were collected on the prevalence of adenomatous polyps and advanced adenomas in 70 patients with ESKD and 70 controls, undergoing their first screening colonoscopy, matched for age, gender, and endoscopist. At the time of the colonoscopy, an average time on HD was 3.2 ± 2.9 yr. The prevalence of adenomatous polyps was significantly higher in ESKD on HD (54.3% vs. 32.9%, p = 0.008) than in controls. In a multivariate analysis controlling for other factors, ESKD on HD remained a risk factor for the presence of adenomas (OR 3.06, 95% CI 1.21, 7.73). No colonoscopy-related complications were reported in the patients with ESKD on HD. We demonstrate a significantly higher prevalence of adenomatous polyps in patients with ESKD undergoing a first screening colonoscopy as part of kidney transplant evaluation. In addition, colonoscopy can be safely performed in this population.
authors.affiliation: Department of Gastroenterology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Saumoy
authors.affiliation: Department of Gastroenterology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Arun B
authors.initials: AB
authors.lastname: Jesudian
authors.affiliation: Department of Public Health, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Aden
authors.affiliation: Department of Nephrology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: David
authors.initials: D
authors.lastname: Serur
authors.affiliation: Riverview Medical Center, Red Bank Gastroenterology, Red Bank, NJ, USA.
authors.forename: Subha
authors.initials: S
authors.lastname: Sundararajan
authors.affiliation: Department of Gastroenterology, Lenox Hill Hospital, New York, NY, USA.
authors.forename: Geethan
authors.initials: G
authors.lastname: Sivananthan
authors.affiliation: Department of Gastroenterology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Gambarin-Gelwan
mesh_terms: D000236:Adenoma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011183:Postoperative Complications; D015995:Prevalence; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: colonoscopy; colorectal cancer; kidney transplant