[Cancer of the bladder and hemodialysis]

Of 324 patients on long-term dialysis treatment, 14 developed malignant tumors. Of these, 4 had bladder tumors. The increased frequency of malignant tumors (4.3%) is underscored. In our setting however, cancer of the bladder accounts for 28.5% of all tumors whereas in the literature a higher frequency has been reported for lymphoma, lung, thyroid or renal cell cancer. A review of the literature has revealed significant differences in frequency and tumor type reported in patients on long-term dialysis. A two-stage diagnostic protocol to detect bladder tumors in patients on dialysis is described. During diagnostic work up, we attempt not to be aggressive in these patients. Due to the high incidence of bladder tumors, we believe that at least the first stage of this diagnostic protocol should be performed in all patients that are symptomatic or require urologic work up prior to inclusion in a kidney transplant program. We report our experience in 14 cases diagnosed as having tumors in a series of 324 patients on dialysis.