Shen Bing, Luo Feng, Yuan Nan, Yin Jiaming, Chai Yalin, Sun Lijie, Zhang Lin, Luo Congjuan
Qingdao University, Qingdao 266071, P.R. China.
The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, P.R. China.
Open Med (Wars). 2024 Aug 23;19(1):20241009. doi: 10.1515/med-2024-1009. eCollection 2024.
The management of patients undergoing bilateral nephrectomy for renal cancer presents significant challenges, particularly in addressing hypotension, anemia, and tumor recurrence during hemodialysis.
A patient diagnosed with renal clear cell carcinoma in 2009 was followed until his demise in June 2022, with detailed documentation of symptoms, signs, laboratory results, diagnosis, and treatment. In the presented case, post-nephrectomy, the patient experienced frequent hypotension and anemia during dialysis, improving with erythropoietin-stimulating agents and subsequently with rosuvastatin. Later, multiple metastases were detected, correlating with normalized blood pressure and hemoglobin.
A literature search up to September 2023 was also conducted, gathering data on hypotension, anemia, and tumor recurrence post-nephrectomy. Literature analysis of six cases revealed a 100% tumor recurrence rate in elderly patients (>50 years).
Treatment of anemia in bilateral nephrectomy patients warrants consideration of medication-induced tumor recurrence, highlighting early kidney transplantation to avoid adverse reactions like hypotension.
对因肾癌接受双侧肾切除术的患者进行管理面临重大挑战，尤其是在血液透析期间应对低血压、贫血和肿瘤复发方面。
一名于2009年被诊断为肾透明细胞癌的患者，一直被跟踪观察直至2022年6月去世，期间对其症状、体征、实验室检查结果、诊断和治疗进行了详细记录。在本病例中，肾切除术后，患者在透析期间频繁出现低血压和贫血，使用促红细胞生成素后情况有所改善，随后使用瑞舒伐他汀后进一步改善。后来，检测到多处转移，这与血压和血红蛋白恢复正常相关。
还进行了截至2023年9月的文献检索，收集了肾切除术后低血压、贫血和肿瘤复发的数据。对6例病例的文献分析显示，老年患者（>50岁）的肿瘤复发率为100%。
双侧肾切除患者的贫血治疗需要考虑药物引起的肿瘤复发，这突出了早期肾移植以避免低血压等不良反应的重要性。
