| [ Summary ] |
The causative factors for the increased prevalence of malignancy in uremic patients have not yet been identified. However, the accumulation of uremic toxins in the blood of uremic patients is considered to be involved in carcinogenesis, due to immune deficiency, along with decreased cellular immunity and/or to their direct cellular effects. Renal replacement therapy, such as hemodialysis, improved immune deficiency to some extent, by removing these uremic toxins. Special uremic toxins, such as phenols and indoles, which are not efficiently removed by hemodialysis, have been noted as important candidates to induce immune deficiency and carcinogenesis. Further, hemodialysis procedures alone may also contribute to carcinogenesis and growth of malignant tumors, by increasing the generation of free radicals and cytokines, which accompany chronic inflammation. Thus, this evidence suggests that various uremic states may increase the prevalence of malignancy in uremic patients. |