Renal cell carcinoma in chronic hemodialysis patients--a 1990 questionnaire study in Japan

Questionnaires were sent to 2,030 dialysis units in Japan in February 1990 to determine the prevalence of renal cell carcinoma in chronic hemodialysis patients. The response rate of 64% covered approximately 65% of the 88,534 dialysis patients in Japan. Renal cell carcinomas were detected in 130 dialysis patients between March 1988 and February 1990. The age of the 130 patients (112 males and 18 females) was 52.6 +/- 10.9 years (mean +/- SD), and the mean duration of dialysis was 106.0 +/- 82.3 months. The clinical diagnosis was based on CT (59 cases) and sonographic examination (48 cases). Only 15 of the patients were symptomatic. The underlying kidney disease was chronic glomerulonephritis in 108 cases. Acquired renal cystic disease was found in 102 of 124 renal cell carcinoma patients (82.3%). Curative nephrectomy was performed in 99 of 129 patients. The mean tumor diameter was 4.2 +/- 2.5 cm, (range 0.5 to 15.0). Bilateral renal cell carcinomas were found in 11 of the 130 patients. Moreover, 19 of 126 patients had metastases. In conclusion, prevalence of renal cell carcinoma in dialysis patients is 41 times higher than that in the general population. In 83.6% of the patients the diagnosis was made by screening tests. Metastasis was observed in 15.1% of patients in this series.