[Increased cancer incidence in terminal kidney failure: potential pathogenetic mechanisms]

Increased incidence of cancer in various sites is observed in patients with end-stage renal disease. A multitude of carcinogenic factors directly or indirectly associated with the disease may be involved. Impaired function of the immune system as well as impaired antioxidant defence, accumulation of carcinogenic compounds partly due to impaired renal elimination, and chronic infection and inflammation are found with increased prevalence in these patients and may contribute to enhanced tumor formation. Furthermore, factors associated with the dialysis treatment, such as bio-incompatibility reactions due to complement activating membranes, immunosuppressive medication in the course of prior unsuccessful renal transplantation, and impairment of DNA repair may also act in concert to accelerate malignant transformation.