Early diagnosis and treatment of renal cell carcinoma of native kidney in kidney transplantation.

BACKGROUND: The frecuency of malignancies in renal transplant (RT) patients is increasing. Renal cell carcinoma (RCC) of native kidneys is one of the most frequent and its outcome can be more aggressive than in general population. OBJECTIVE: To evaluate the incidence and prognosis of RCC in renal transplant patients followed in our transplantation unit. METHODS: Between January 1997 and December 2009, 683 patients underwent kidney transplant at our hospital. Ultrasonography of the native kidneys was annually performed in all renal transplant patients. When suspect solid masses were found at ultrasonography, patients underwent computed tomography. If the suspicion was confirmed, nephrectomy was performed. RESULTS: 14 radical nephrectomies were performed in 12 patients due to suspect CCR. In 11 nephrectomies (corresponding to 9 patients), anatomopathologic diagnosis was CCR (incidence 1.5%). Histologic stage was T1N0M0 in all cases. In the other 3 RT, the diagnosis was complicated renal cyst. Those patients without carcinoma had polycystic kidney disease. The time on dialysis before CCR diagnosis was 36.7 ± 24.3 months and the interval between RT and diagnosis was 39 ± 25.8 months. After a mean follow-up of 58.6 ± 38.6 months, the outcome of all cases has been excellent, without tumor recurrence. CONCLUSIONS: Annual renal ultrasonography plays a key role in the early diagnosis of CRR. The early treatment of this pathology is associated with an excellent prognosis in RT patients.

[The endourological treatment of distal ureteral fistulae in the kidney transplant. The exclusion or "dry" technic]. / Tratamiento endourológico de las fístulas de uréter distal en el trasplante renal. Técnica de exclusión o "seca".

The present study reports our experience in the endourological treatment of fistulas of the distal ureter in renal transplant patients. The temporary urinary exclusion or dry technique was effective in 8 of the 10 patients. We advocate the use of this simple and safe technique which achieves excellent results.

[Comparative biochemical study of serum and residual peritoneal fluid in periodic peritoneal maintenance dialysis (author's transl)]. / Estudio bioquímico comparativo del suero y líquido peritoneal residual en la diálisis peritoneal crónica intermitente.

The increasing use of peritoneal maintenance dialysis in end renal insufficiency calls for a better understanding of its advantages, and a comparative study of residual fluid as a partial substitute for serum may be helpful in this respect. A comparative biochemical study was carried out with 53 samples taking simultaneously from 16 patients in peritoneal dialysis. Statistical results showed linear correlation coefficient to be higher than 0.64 in BUN, phosphorus, creatinine, uric acid, calcium and potassium, which allows a statistically certain conclusion to be drawn to the serum levels of residual peritoneal fluid. The results of glucose, chloride, bilirubin, osmolality, LDH, bicarbonate, albumin, cholesterol, sodium, globulines and alkaline phosphatase studies, gave an insufficient linear correlation coefficient, which makes it impossible to offer the necessary guarantees for the use of residual fluid.