Uraemia with concomitant urothelial cancer

We report our experience with 3 uraemic patients who were found to have transitional cell carcinoma of the renal pelvis, ureter and urinary bladder after undergoing haemodialysis for an average of 18 months (range 11-28). The underlying causes of renal failure were chronic glomerulonephritis or pyelonephritis. Bloody urethral discharge was the cardinal symptom. Because of anuria, it was often discovered at a late stage. In spite of their poor general condition and advanced stage, palliative surgical intervention was still performed. After a mean follow-up of 9 months, progression of disease was noted in 1 patient. The importance of regular follow-up in patients with end-stage renal disease for early detection of concomitant cancer cannot be over-emphasised. Uraemic patients with urothelial cancer should be treated in the same way as non-uraemic patients, since aggressive surgical intervention may improve their quality of life and prolong their survival.