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Cáncer en pacientes en diálisis por enfermedad renal terminal: un estudio internacional de colaboración
P Maisonneuve1, L Agodoa, R Gellert
1Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. pmaison@ieo.it
Lancet (London, England)
|July 17, 1999
Resumen
Los pacientes con enfermedad renal en estadio terminal (ESRD) tienen un mayor riesgo general de cáncer, especialmente los individuos más jóvenes. Los cánceres específicos como el riñón y la vejiga son más comunes, posiblemente debido a factores virales y pérdida de la función renal.
Área de la Ciencia:
- Nefrología Nefrología.
- Oncología Oncología.
- Epidemiología La epidemiología.
Sus antecedentes:
- Estudios previos sugieren una mayor incidencia de cáncer en pacientes con enfermedad renal en etapa terminal (ESRD).
- Existe incertidumbre con respecto a tipos específicos de cáncer y subgrupos de pacientes afectados.
Objetivo del estudio:
- Para investigar el riesgo de cáncer en una gran cohorte de pacientes en diálisis sin trasplante.
- Para identificar cánceres específicos y datos demográficos de pacientes asociados con un mayor riesgo.
Principales métodos:
- Se reunió una cohorte de 831.804 pacientes con ESRD en diálisis de 1980 a 1994.
- La incidencia del cáncer se comparó con las poblaciones de fondo durante 2.045.035 personas-año.
Principales resultados:
- El riesgo general de cáncer fue elevado (proporción de incidencia estandarizada de 1,18).
- Los pacientes más jóvenes (<35 años) mostraron un riesgo significativamente mayor (3.68).
- Se observaron riesgos elevados para los cánceres de riñón (3.60), vejiga (1.50) y órganos endocrinos (2.28).
Conclusiones:
- Los pacientes con ESRD enfrentan un mayor riesgo general de cáncer, con un patrón similar al de los pacientes trasplantados.
- El exceso de riesgo está relacionado con la enfermedad renal / del tracto urinario y la susceptibilidad a la carcinogénesis viral.
- El riesgo es mayor en pacientes más jóvenes y disminuye con la edad.
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