当院における透析腎癌症例の検討

Abstract

Because of a higher incidence in dialysis patients, regular screening for renal cell carcinoma (RCC) is considered beneficial in this population. RCC is associated with a high incidence of acquired cystic disease of the kidney (ACDK), and it has been suggested that these conditions are related. This study was designed to examine the efficacy of RCC screening for dialysis patients and the relationship between RCC and ACDK. This study enrolled 624 dialysis patients treated between August 2005 and June 2011 at our hospital. Screening for RCC was performed by annual abdominal ultrasonography. Factors analyzed were as follows: RCC morbidity, incidence, diagnostic method, and survival rate; and the RCC and ACDK comorbidity rate. RCC was diagnosed in 12 patients. RCC morbidity and incidence rates were 2.08% and 0.33%, respectively. Diagnosis of RCC was made by abdominal ultrasonography screening (N = 7, group A), abdominal ultrasonography or computed tomography for other disease (N = 2, group B) or detailed examination after appearance of symptoms (N = 3, group C). With the exception of one death from other disease, all group A and group B patients survived the follow-up period. In contrast, all group C patients died of RCC within 6 months of diagnosis; only one of these patients underwent RCC screening. The RCC/ACDK comorbidity rate was 91.7% (p = 0.0026). Results indicate that regular screening of dialysis patients for RCC is beneficial. RCC was associated with a high incidence of ACDK, indicating that there is a relationship between these two diseases.