By Isao Ishikawa
I were thinking about the remedy of persistent renal insuf? ciency for forty years, starting with peritoneal dialysis instantly after commencement from clinical tuition in 1965, then with hemodialysis in 1967 after I ? rst skilled it in Kanazawa, and with renal transplantation seeing that 1972, whilst i used to be learning within the usa. in this interval, the variety of dialysis sufferers has persisted to extend swiftly to the current ? gure of 257 765 (at the tip of 2005), and with miraculous raises within the survival expense. even though, new and unforeseen pathological stipulations have additionally seemed as problems of long term dialysis. this type of includes polycystic alterations and their malignant transformation in diseased kidneys. due to the fact i've got studied those polycystic alterations and their malignant transformation for a few years, i made a decision to assemble the result of my paintings in a publication. Such stipulations of diseased kidneys pose severe difficulties, quite in Japan, the place renal transplantation is played very every now and then in comparison with different international locations, and loads of sufferers are controlled via dialysis over a protracted period.
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Additional info for Acquired Cystic Disease of the Kidney and Renal Cell Carcinoma: Complications of Long-Term Dialysis
7 Diagnosis Since renal cell carcinoma is rarely symptomatic, dialysis patients must be screened periodically by imaging techniques to ensure its early detection. Imaging studies are essential when gross hematuria is observed [11,93,94]. 1 Ultrasonography Ultrasonography is performed first for imaging screening because it is not invasive, can readily be repeated, and is inexpensive . Its disadvantages are that the effectiveness is largely operator-dependent, that delineation of small tumors is difficult, that renal cell carcinomas are imaged as masses with an internal echo while cysts have no internal echo, and that small kidneys are difficult to image if there is much fat (Table 13).
000 NS NS NS words, the duration of dialysis was 10 years or longer in about half the dialysis patients with renal cell carcinoma. When the results of the surveys were compared, the number of renal cell carcinoma patients with a longer duration of dialysis gradually increased (Table 9). When the occurrence of renal cell carcinoma was compared between patients with and without acquired cystic disease of the kidney (ACDK), the patients with ACDK complicated by renal cell carcinoma were more often males, were younger, and had a longer duration of dialysis (Table 10).
The occurrence of renal cell carcinoma showed no racial difference, but was less frequent in continuous ambulatory peritoneal dialysis (CAPD) patients. They suggested that male sex, long-term dialysis, and aging were risk factors for RCC. We carried out a total of 12 surveys in the form of questionnaires concerning renal cell carcinoma in dialysis patients every 2 years from 1982 to 2004 [55,57,63,78–86]. 191% of all patients). 438%) in those who had undergone dialysis for 10 years or longer. These figures show that the incidence of renal cell carcinoma increases with the duration of dialysis, and that this increase is about four times greater in those with a 10-year history of dialysis or longer compared with those with a history of less than 10 years (Fig.