Transitional cell carcinoma in dialysis patients.

Area of Science:

• Nephrology
• Urology
• Oncology

Background:

• Uremic patients undergoing dialysis are a unique population with potential risk factors for malignancy.
• The incidence of urothelial cancer, particularly transitional cell carcinoma (TCC), in this group requires further investigation.

Purpose of the Study:

• To determine if there is an increased incidence of urothelial cancer, specifically TCC, in patients on maintenance dialysis.

Main Methods:

• A retrospective chart analysis of 1,910 uremic patients on maintenance dialysis from January 1987 to December 1997.
• Inclusion criteria focused on urinary tract cancers diagnosed after the initiation of dialysis.

Main Results:

• Nineteen patients (0.99%) were diagnosed with urinary tract cancers post-dialysis initiation, including 17 with TCC.
• The average time from dialysis initiation to TCC diagnosis was 38.3 months.
• Most TCC cases (82.3%) were diagnosed at early stages (0 or A), with painless gross hematuria as the primary symptom.

Conclusions:

• The incidence of TCC (0.89%) in dialysis patients appears higher than in the general population.
• Potential contributing factors include immunosuppression, dialysis procedures, and chronic bladder irritation.
• Regular monitoring for hematuria may facilitate early TCC detection in dialysis patients.