Clinical study of urogenital tumors occuring in maintenance hemodialysis patients treated at Sasebo City General Hospital during the past 10 years

An increased incidence of malignant tumors in maintenance hemodialysis patients has been pointed out. In particular, that of uro-genital tumors has been reported to be high. We report a clinical study of uro-genital tumors in maintenance hemodialysis patients treated at our hospital during the last 10 years. Between January 1993 and December 2002, 1294 patients underwent hemodialysis in our hospital. Of these, 145 patients (11.2%) developed malignant tumors. Among patients with malignant tumors, 29 patients (20.0%) had urogenital tumors. The classification of urogenital tumors consisted of 13 renal cell carcinomas (44.8%), 6 renal pelvic and ureteral tumors (20.7%), 8 bladder tumors (27.6%) and 2 prostate cancers (6.9%). The initial symptom was hematuria and urethral bleeding in 14 cases (48.2%), screening test by computed tomography or ultrasound sonography detected the tumor in 11 cases (37.8%) and abdominal pain, dysuria, positive urine cytology and high serum level of prostatic specific antigen were found in 1 case each. The mean age of patients with renal cell carcinoma was younger than that of patients with urinary epithlial tumors. The duration of hemodialysis in patients with renal cell carcinoma arising from acquired cystic disease of the kidney was longer than that of those with other types of malignant tumors. Since Matas first reported the high incidence of malignant tumors in hemodialysis patients, a number of similar reports have appeared, especially with regard to urinary tract malignancies. Malignant tumors in hemodialysis patients can easily be detected by the screening test. So, the for urinary tract malignancy should be routinely performed.