Renal Carcinoma and Dialysis in End-Stage Renal Disease

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Abstract
Patients (5) receiving long-term hemodialysis (mean duration of 6.4 yr) were described, 8 renal carcinomas were found. In 4 patients, the carcinoma was confirmed by tissue pathology, while the 5th patient had multiple (4) areas of neovascularity on selective renal arteriography. Two patients died of metastases. In 4 patients the diagnosis was initially made with selective renal arteriography and in the remaining 1, with sonography and computerized tomography. In 3 of the 4 arteriography showed diffuse cystic degeneration; pathologic findings revealed renal carcinoma and the changes of "end-stage" disease. Two patients had brief pharmacologic immunosuppression during unsuccessful renal tranplantation 6-yr earlier. There is apparently an increased risk of renal carcinomas in end-stage renal disease, a risk that appears to be independent of pharmacologic immunosuppression.