Theme |
Malignancy in Chronic Renal Failure |
Title |
Viral hepatitis and hepatocellular carcinoma in chronic dialysis patients |
Publish Date |
2001/06 |
Author |
Hisao Oguchi |
Department of Internal Medicine, Nagano Prefectural Kiso Hospital |
Author |
Mamoru Kobayashi |
Department of Internal Medicine, Nagano Prefectural Kiso Hospital |
Author |
Yoshiyuki Nakano |
Department of Internal Medicine, Nagano Prefectural Kiso Hospital |
[ Summary ] |
A high frequency (15%) of anti-hepatitis C virus antibodies are still observed in Japanese hemodialysis patients, but the prevalence of HBs antigens has decreased dramtically (2%), In patients with transfussion-associated chronic hepatitis C followed for move than 20 years, progression to hepatocellular carcinoma (HCC) has been found in 25%. Therefore, we are concerned about the high rate of HCC in long-term hemodialysis patients. An overview of regular dialys-is treatment in Japan as of Dec. 31 1999 suggests that some patients already had HCV-related chronic liver diseases (liver cirrhosis or HCC) at the begin ning of hemodialysis treatment. On the other hand, in long-term hemodialysis patients observed over the last 20 years, the development of HCC is not great. Taking into account the high prevalence of HCV infection in hemodialysis patients, the frequency of HCC development in long-term hemodialysis patients may be lower than anticipated. It is very important that systemic monitoring of hemodialysis patients with HCV-related chronic active hepatitis or liver cirrhosis must be done at least every six months, or even more often. This should be by done through ultrasonographic examination and measurement of serum alpha fetoprotein. |