To screen or not to screen renal cell cancer in a kidney transplant patient.

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Hippokratia Pub Date : 2023-04-01

K Kaynar, L Alizade, Ö Uyar, S Mungan, K Rashidzade

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引用次数: 0

Abstract

Background: The prevalence of malignancies is higher among kidney transplant recipients (KTR) than general population. Although the incidence of renal cell cancer (RCC) after KTR was reported as 0.6 % with a high mortality rate of 13.9 %, none of the guidelines except the European Best Practice Guideline (EBPG) recommends RCC screening based on cost-effectiveness and lack of solid evidence. The EBPG recommends RCC screening in native kidneys (not the allograft) by ultrasonography (USG) every 1-3 years.

Case description: A 55-year-old male patient who had a kidney transplant from a living donor 14 years before, presented with sudden onset uncontrolled hypertension (180/110 mmHg) and rapid deterioration in graft functions (increase in serum creatinine to two-times baseline). Evaluations revealed RCC in the allograft. Abdominal pain, hematuria, fever, weight loss, flu-like syndrome, recurrent urinary tract infections, weakness, hypertension, and allograft dysfunction are reported as the main complaints and signs of RCC in KTR patients. Our patient's findings were hypertension and allograft dysfunction.

Conclusion: It is essential to follow EBPG for KTR and not to forget the annual USG for screening of RCC both in native kidneys and allograft. HIPPOKRATIA 2023, 27 (2):69-71.

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肾移植患者的肾细胞癌筛查与否 Kaynar.

背景：肾移植受者（KTR）的恶性肿瘤发病率高于普通人群。尽管有报告称肾移植后肾细胞癌（RCC）的发病率为 0.6%，死亡率高达 13.9%，但基于成本效益和缺乏确凿证据，除《欧洲最佳实践指南》（EBPG）外，其他指南均不建议进行 RCC 筛查。欧洲最佳实践指南（EBPG）建议每1-3年通过超声波检查（USG）对原生肾（非异体肾）进行RCC筛查：一名 55 岁的男性患者在 14 年前接受了活体肾移植，突然出现无法控制的高血压（180/110 mmHg），且移植物功能迅速恶化（血清肌酐上升至基线的两倍）。评估结果显示异体移植体内存在 RCC。据报道，腹痛、血尿、发热、体重减轻、流感样综合征、反复尿路感染、虚弱、高血压和同种异体移植功能障碍是 KTR 患者 RCC 的主要主诉和体征。我们患者的症状是高血压和异体移植功能障碍：结论：KTR 患者必须遵循 EBPG，同时不要忘记每年进行 USG 检查，以筛查原生肾和异体肾的 RCC。Hippokratia 2023, 27 (2):69-71.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hippokratia MEDICINE, GENERAL & INTERNAL-

CiteScore

1.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hippokratia journal is a quarterly issued, open access, peer reviewed, general medical journal, published in Thessaloniki, Greece. It is a forum for all medical specialties. The journal is published continuously since 1997, its official language is English and all submitted manuscripts undergo peer review by two independent reviewers, assigned by the Editor (double blinded review process). Hippokratia journal is managed by its Editorial Board and has an International Advisory Committee and over 500 expert Reviewers covering all medical specialties and additionally Technical Reviewers, Statisticians, Image processing Experts and a journal Secretary. The Society “Friends of Hippokratia Journal” has the financial management of both the printed and electronic edition of the journal.