Urological Malignancy in Chronic Dialysis Patients

A retrospective study was conducted in order to investigate the clinical features of urological malignancy among dialysis patients. During a study period of 16 years, 63 patients (20 males and 43 females) revealed urological malignancies, these were derived from 7,503 uremic patients, constituting an incidence of 0.84%. The mean age of this group of 63 patients was 60.9±11.0 (29~85) years , and their mean duration of dialysis was 36.2±34.0 (2~144) months. Chronic glomerulonephritis was the most common underlying renal disease. Gross hematuria was the most common presenting symptom (92.1%) and hydronephrosis was the most commonly associated image finding. The categories of malignancy included transitional cell carcinoma (TCC; 57/63), renal cell carcinoma (RCC; 3/63), rhabdomyosarcoma (1/63), squamous cell carcinoma (1/63), and concurrent TCC and RCC (1/63). Over a mean follow-up period of 28. 6±25.7 months, 59.3% patients survived, with four patients being lost to follow up. Twenty patients suffered a recurrent tumor, all of whom were, originally, TCC patients (37.0%). We conclude that TCC is the most common urological malignancy among chronic dialysis patients. Most of those patients who developed cancers did so during the early period of their commencing dialysis, subsequent to presentation of with gross hematuria. We emphasize that the early detection of malignancy is of crucial importance for chronic dialysis patients. (Acta Nephrologica 2002: 16: 19-24)