臨牀透析 Vol.25 No.2(4-7)


特集名 透析患者のスクリーニング検査 -- 透析合併症の防止と健診
題名 透析患者にとって重要となるスクリーニング (7) 画像診断:ACDK腎癌
発刊年月 2009年 02月
著者 石川 勲 浅ノ川総合病院腎臓内科
【 要旨 】 透析患者は一般人より腎癌の発生頻度が高い.透析期間が長いほど腎癌発生が多いのは多胞化萎縮腎(ACDK)と関係するからである.一般人では腎癌の頻度が低いため,人間ドックでスクリーニングが行われても対策型検診としては通常行われない.一方,透析患者の腎癌スクリーニングは推奨されている.透析10年以上の男性,ACDKの著しい患者,腎移植予定者には必須である.急速進行例(rapid type)は予後が不良であるが,ほかの大部分の腎癌はどのような自然経過をとるかまだ解明されていない.そのため,適正なスクリーニングの回数など科学的エビデンスはまだない.
Theme Preventive Medical Screening and Health Check-ups for Dialysis patients
Title Diagnostic imagings for ACDK -- related renal cell carcinoma
Author Isao Ishikawa Division of Nephrology, Asanogawa General Hospital
[ Summary ] The incidence of renal cell carcinoma (RCC) in dialysis patients is higher than that observed in the general population. The longer the duration of hemodialysis, the higher the incidence of RCC. This is because the development of RCC is related to the presence of acquired cystic disease of the kidney (ACDK). Screening for RCC is not usually performed in the general population, since the incidence of RCC is low, although screening for RCC may be performed as a part of general heath check-ups. Screening for RCC in dialysis patients is recommended because of its high incidence and lack of symptoms. It is especially necessary for dialysis patients who have received treatment for more than 10 years, dialysis patients with ACDK, and potential recipients of renal transplantation to have this screening. However, there is still no evidence indicating the appropriate number of screens per year. Although prognoses for rapidly progressive tumorsare poor, the natural history of major RCCs in dialysis patients remains to be elucidated.
戻る