Renal cell carcinoma in patients receiving hemodialysis treatment

Background. In patients with end-stage renal disease (esrd), renal cell carcinoma (rcc) is detected more often than in the general population. in order to improve the results of treatment of patients in this category, we conducted a retrospective analysis of our own experience. material and methods. During the period from 2010 to 2020, nephrectomy (ne) for rcc was performed in 26 patients treated with hemodialysis (hd) at the city clinical hospital №52 of the moscow healthcare department. To identify predictors of rcc, 100 patients treated with hd during the indicated period were randomly selected as a control group. results. significant risk factors for rcc were only male gender (aor 5.1; 95% cl 1.34-14.4; p=0.015) and the presence of multiple kidney cysts (or=3.2, 95% cl 1.56-16, 43; p=0.008). A bimodal increase in the frequency of rcc was noted: in the first year after the onset of hd and 5 years later. after ne, bleeding due to systemic hypocoagulation was registered only in one case. hyperkalemia was noted in 5 (19.2%) patients immediately after laparoscopic ne. Based on the tnm stage, the uicc (university of california los angeles integrated staging system) nomogram, and the leibovich score, a favorable oncological prognosis was noted in 17 (65.4%) patients. the median follow-up of patients after ne was 20 months (q1-q3: 8.5-45), with a minimum of 2 months and a maximum of 72 months. In none of the cases progression of rcc was noted. Conclusion. the high-risk group for developing rcc was male patients with multiple kidney cysts. After laparoscopic ne, monitoring of blood potassium levels is required. The vast majority of patients after surgical treatment were characterized by a favorable oncological prognosis and they could be considered for kidney transplantation without an additional period of follow-up.

kidney cancer, end-stage renal disease, nephrectomy, kidney transplantation