Renal masses in end-stage renal disease patients on dialysis

Lee, Mi Jung; Shin, Dong Ho; Kim, Hyun Min; Park, Hyun Sung; Park, Jung Tak; Chang, Tae Ik; Yoo, Tae Hyun; Kang, Shin Wook; Choi, Kyu Hun

Abstract

BACKGROUND/AIMS
End-stage renal disease (ESRD) patients are at a higher risk for cancer, especially renal cell carcinoma (RCC). Acquired cystic kidney disease (ACKD) and long duration of dialysis predict RCC in these patients. We explored the cilnical and pathologic characteristics of renal masses and the factors predicting malignant tumors.
METHODS
The study examined the medical records of 38 ESRD patients who underwent partial/total nephrectomy due to renal masses diagnosed by abdominal ultrasound and computed tomography at YUHS from January 1995 to December 2009.
RESULTS
Renal masses were recorded in 38 patients (21 males) with a mean age of 48.3+/-13.2 years. Twenty patients (52.6%) were on hemodialysis and 18 patients (47.4%) were on peritoneal dialysis, for a mean period of 106.4+/-62.5 months. ACKD was reported in 23 patients (67.6%). Of the 38 renal masses, 23 (60.5%) were diagnosed as malignant tumors and 15 (39.5%) were benign tumors. Clear cell RCC (n=16) and hematoma (n=6) was the predominant respective types. The patients with malignant tumors had a significantly longer duration of dialysis (122.3+/-61.8 vs. 81.1+/-56.7 months, p<0.05) and a higher prevalence of ACKD (87.0 vs. 46.7%, p<0.01) compared to the patients with benign tumors.
CONCLUSIONS
The most common renal mass in ESRD patients was RCC. Malignant tumors were significantly associated with a longer duration of dialysis and ACKD. Therefore, early evaluation and treatment of RCC are mandatory in long-term dialysis patients with ACKD.