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Tumores de vejiga en pacientes parapléjicos sometidos a terapia de reemplazo renal
M Yaqoob1, P McClelland, G M Bell
1Royal Liverpool University Hospital, UK.
Lancet (London, England)
|December 21, 1991
Resumen
Los pacientes con vejiga neurogénica sometidos a diálisis se enfrentan a un alto riesgo de tumores de vejiga urinaria. Se recomienda un cribado urológico regular y una posible cistectomía antes del trasplante de riñón para mitigar este riesgo.
Área de la Ciencia:
- Nefrología Nefrología.
- Urología Urología Urología.
- Oncología Oncología.
Sus antecedentes:
- La enfermedad renal en estadio terminal (ESRD) en pacientes con vejiga neurogénica, a menudo debido a la espina bífida o lesión de la médula espinal, requiere hemodiálisis regular.
- Estos pacientes también pueden someterse a un trasplante renal.
- El riesgo de tumores de la vejiga urinaria en esta población específica no está bien establecido.
Objetivo del estudio:
- Para investigar la incidencia de tumores de la vejiga urinaria en pacientes adultos con ESRD secundaria a la vejiga neurogénica sometidos a hemodiálisis.
- Para evaluar la aparición de estos tumores en pacientes que han recibido trasplantes renales.
Principales métodos:
- Se realizó un seguimiento de una cohorte de catorce pacientes adultos con ERDE debido a la vejiga neurogénica.
- Los pacientes se sometieron a hemodiálisis regular durante una duración media de 20 meses.
- Siete pacientes recibieron trasplantes renales; el estado urológico fue monitoreado.
Principales resultados:
- Cuatro de los catorce pacientes (28,6%) desarrollaron tumores de la vejiga urinaria.
- Tres casos de carcinoma de células escamosas se produjeron en pacientes en diálisis.
- Un carcinoma de células de transición poco diferenciado fue diagnosticado en un paciente trasplantado.
- Los cuatro pacientes presentaron una enfermedad metastásica generalizada y fallecieron a las 8 semanas del diagnóstico.
Conclusiones:
- Los pacientes con vejiga neurogénica en diálisis tienen un riesgo significativo de desarrollar tumores de la vejiga urinaria.
- La evaluación urológica regular es crucial para estos pacientes, incluso después de iniciar la diálisis.
- La cistectomía total profiláctica antes del trasplante renal puede reducir el riesgo de estos tumores raros pero agresivos.
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