Renal cell carcinoma in peritoneal dialysis patients

Abstract

Renal cell carcinoma is a rare but seriouscomplication in ESRD patients. In thesepatients the incidence of renal cell carcinoma(RCC) is 20–40 times higher than in thegeneral population. We performed aretrospective study to measure the incidencerate, prevalence, characteristics and survivalamong our peritoneal dialysis (PD) patientsdiagnosed with renal cell carcinoma.The study was carried out among 607 patientswho were on the PD program from January 1997 toJune 2002. RCC was detected in eight patients(four males and four females) with mean age of52.1 ± 10.6 years. Among these eight patientsfour were new cases that were diagnosed beforethe patients were started on dialysis (three innative kidneys and one in a transplantedkidney). In the other four patients the RCC wasdiagnosed after they had been on dialysis for33–204 months (mean 60.75 ± 50.48). Wefound an incidence rate of 1.3 per 1000patients per year and a prevalence of 1.3%.Six of the eight patients had renal cysts.Tumor size was less than 7 cm in seven patientsand in the other patient it was 8.5 cm. Sevenof eight patients were alive at the time ofstudy with a survival time ranging from 3–138months (mean 122.25 ± 88.2) months. In onepatient, the RCC metastasised to the scalp,and, in two other patients, the tumorssubsequently involved the second kidney. Acardiovascular complication was the cause ofone death. Two patients received a renaltransplant 36 and 66 months after diagnosis.We conclude that despite the low rate ofmetastases and mortality in our study, regularultrasonography should be added to the followup of PD patients. Renal transplantation can beconsidered in these ESRD patients with RCC;however, close follow up for metastases isrecommended.