| ObjectiveIn recent years, with hemodialysis and peritoneal dialysis technology improved, the survival of patients with chronic renal failure (CRF) has significantly extended. But more and more studies have found that the incidence of cancer in patients with CRF particular in uremia is several times than the normal population. The high incidence of malignant tumors in patients with CRF has a serious impact on their survival time and quality of life, but the risk factors for malignancy has not been fully clarified. So exploring this question is the urgent need to address important medical problems. Patients with CRF in uremia having a higher incidence of tumors have been recognized by scholars. But up to now, the risk of cancer and related factors for the patients with CRF in azotemia is not yet epidemiological survey analysis. This study was to further explore the different periods of patients with CRF (azotemia and uremia) about the risk of malignancy, cancer risk factors and the incidence of tumor type, tumor control for clinicians to provide a theoretical basis. We hope to early detect and early intervene so as to reduce the mortality and prolong patient survival time and improve their quality of life for patients with malignancies.MethodsSelect complete clinical data of 609 patients with chronic renal failure cases(rule out the patients caused by malignancy).Including 304 cases of patients with azotemia, uremia patients 305,Of the selected cases were retrospectively analyzed and summarized, each case selected will be recorded by the general information such as age,gender,primary disease(such as Primary glomerulonephritis, Diabetic nephropathy, Hypertensive nephropathy, Lupus nephritis,obstructive nephropathy,Aristolochic acid nephropathy,Analgesic nephropathy,Chronic pyelonephritis,Chronic uric acid nephropathy,Polycystic kidney disease,etc.) Comorbidity(epatitis B, hepatitis C, acquired renal cystic disease, etc.),Serum creatinine (Cr), blood urea nitrogen (BUN), glomerular filtration rate (GFR), body mass index (BMI), serum albumin (ALB), hemoglobin (Hb).The patients with Uremia are required to record dialysis modality and dialysis age. If the tumors were detected, all these indicators above mentioned are derived from the moment of diagnosing the tumor,and record the tumor types. All measurement data are recorded by ( x±s) means thatRates compared by X2 test,Between groups using t test.Tumor-related factors were analyzed by Logistic regression analysis.All statistical methods were conducted using statistical software SPSS15.0.Results1.Azotemia and uremia on the general situation of two groups of patients. The cancer incidences in the stage of the azotemia and uremia were 1.32% and 4.26% respectively.The overall incidence of patients with CRF was 2.79%,patients in uremic have a higher incidence of cancer than patients in azotemia.The difference was statistically significant(P<0.05). Hemodialysis patients has a 6.38% incidence of malignant tumors,Peritoneal dialysis was 0.8% incidence of malignant tumors,Hemodialysis patients with a high incidence of malignancy in peritoneal dialysis patients , The difference was statistically significant(P<0.05).2.Azotemia and uremia on the tumor situation of two groups of patients.There were 17 cases of malignant tumor patients in azotemia and uremia patients, the highest incidence of urinary system cancer was 41.2%,a total of 7 cases.Followed by digestive system tumors, a total of 5 patients, accounting for 29.4%.Four of them occurred in azotemia were 2 cases of malignant bladder cancer, 1 case of gastric cancer, 1 case of breast cancer.17 cases of malignant tumor patients, average age (64.50±12.35) years.The average duration of dialysis (60.61±32.46) months.The average duration of dialysis (60.61±32.46) months. A total of 592 cases of non-tumor patients, average age (50.15±12.80) years, the average age of dialysis (50.32±24.46) months, glomerular filtration rate (34.67±15.82) ml / min.Cancer patient's age, duration of dialysis patients than non-tumor length, the difference was statistically significant.Glomerular filtration rate in patients with cancer than non-cancer patients, the difference was statistically significant(P<0.05).3.CRF patients with primary disease,concomitant disease and the tumor incidence. In the original pathogenesis of patients with CRF malignancy,the incidence of tumor in the aristolochic acid nephropathy was 27.27%, accounting for 8.33% in analgesic nephropathy, 3.66% in chronic glomerulonephritis, 2.86% in hypertensive nephropathy, 1.72% in diabetic nephropathy. Tumor incidence was significantly different in different primary disease (P <0.01).609 patients with CRF include 81 cases with acquired renal cystic disease, the incidence rate is 13.31%. in which 2 cases of renal cell carcinoma, tumor incidence was 2.47%.4.CRF patients with the risk factors of cancer Logistic regression analysis showed that age, duration of dialysis age, glomerular filtration rate is the risk factors of the tumors.5.The treatment and prognosis of tumor patients There are 65 patients with uremia and dialysis died during follow-up, in 305 patients with uremia and dialysis. The cause of death were 19 cases of rdiovascular diseas(e29.2%), 14 cases of cerebral vascular disease(21.6%),9 cases of infection(13.8%),8 cases of systemic failure(12.3%),6 cases of tumor(9.3%) ,The other is nine cases(13.8%). Malignancy in dialysis patients leading to the fifth cause of death.Conclusion1. Patients with uremia have a higher incidence of malignant tumors than azotemia.2.Hemodialysis patients have a higher tumor incidence than peritoneal dialysis patients.3.The incidence of malignant tumors has a higher rate in primary disease of aristolochic acid nephropathy in patients with CRF than in other kidney disease.4.The patient's age, duration of dialysis ages and glomerular filtration rate are the risk factors of malignancy. With the increase of age and dialysis duration,patients with CRF have a higher risk of malignant tumors. Particularly, along with the decline of the glomerular filtration,the risk of cancer will increase.5. Urinary system tumors accounting for 41.2% was the first rank in the patients of CRF with malignancy,followed by digestive system tumors, accounting for 29.4%.6. Malignancy in dialysis patients leading to the fifth cause of death. |
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