Renal cell carcinoma in patients on dialysis

Introduction. In patients with end-stage chronic renal failure (ESRD), renal cell carcinoma (RCC) is detected more often than in the general population. In order to improve the results of treatment of this category of patients, we conducted a retrospective analysis of our own experience. Materials and methods. In the period from 2010 to 2020, 26 patients undergoing hemodialysis underwent a nephrectomy for RCC in the State hospital № 52, Moscow Department of Health. To identify predictors of RCC, 100 patients undergoing hemodialysis treatment over the specified period were randomly selected as a control group. Results. Significant risk factors for RCC were only male (AOR 5.1; 95%CI 1.34-14.4; p=0.015) and acquired cystic kidney disease (ACKD), (AOR 3.2; 95% CI 1.56-16.43; p=0.008). There was a bimodal increase in the frequency of RCC: in the first year after the start of hemodialysis and 5 years later. After nephrectomy, only in one case there was bleeding due to systemic hypocoagulation. Hyperkalemia was observed in 5 (19.2%) patients immediately after laparoscopic nephrectomy. Based on the TNM stage, the UICC nomogram (University of California Los Angeles Integrated Staging System) and the Leibovich score, a favorable cancer prognosis was observed in 17 (65.4%) patients. The median follow - up for patients after nephrectomy was 20 months (Q1-Q3:8.5-45 months), the minimum period was 2 months, and the maximum period was 72 months. In no case was there any progression of RCC. Conclusion. Male patients with ACDK are at high risk of developing RCC. After laparoscopic nephrectomy shown to control the level of potassium the blood. The vast majority of patients after surgical treatment have a favorable oncological prognosis and may be considered for kidney transplantation without an additional follow-up period.