Takahashi S, Shirai T, Ogawa K, Imaida K, Yamazaki C, Ito A, Masuko K, Ito N
First Department of Pathology, Nagoya City University Medical School, Japan.
Acta Pathol Jpn. 1993 Nov;43(11):674-82. doi: 10.1111/j.1440-1827.1993.tb02552.x.
Step-sections of 96 whole kidneys from 50 chronic hemodialysis patients were subjected to a histopathological and quantitative investigation with regard to the development of renal neoplastic lesions. The range of hemodialysis duration was from 1 to 222 months. A total of 349 renal cell adenomas were found in 41 cases (82%). They were commonly multiple and present bilaterally. Renal cell carcinomas were evident in four cases (8%), with hemodialysis durations of 54, 57, 112 and 222 months. The incidence of adenomas increased in a hemodialysis duration-dependent manner, indicating a high risk of renal cell tumor development in chronic hemodialysis patients. Furthermore, acquired cystic disease of the kidney (ACDK) was also observed in 12 cases (24.0%), where the mean hemodialysis period was 143.4 +/- 48.0 months. This value was significantly longer than that of non-ACDK cases (P < 0.001). There was, however, no clear relationship between the appearance of ACDK and renal cell tumors. The present results underline the necessity for attention to possible neoplasia of the kidney in patients on long-term hemodialysis.
对来自50例慢性血液透析患者的96个全肾的连续切片进行了关于肾肿瘤性病变发展的组织病理学和定量研究。血液透析持续时间为1至222个月。41例（82%）共发现349个肾细胞腺瘤。它们通常为多发且双侧存在。4例（8%）出现肾细胞癌，血液透析持续时间分别为54、57、112和222个月。腺瘤的发生率以血液透析持续时间依赖的方式增加，表明慢性血液透析患者发生肾细胞肿瘤的风险很高。此外，12例（24.0%）还观察到获得性肾囊肿病（ACDK），其平均血液透析时间为143.4±48.0个月。该值显著长于非ACDK病例（P<0.001）。然而，ACDK的出现与肾细胞肿瘤之间没有明确的关系。目前的结果强调了对长期血液透析患者肾脏可能发生肿瘤的关注的必要性。
