High prevalence of colon adenomas in end‐stage kidney disease patients on hemodialysis undergoing renal transplant evaluation

Saumoy, Monica; Jesudian, Arun; Aden, Brandon; Serur, David; Sundararajan, Sri Hari; Sivananthan, Geethan; Gambarin‐Gelwan, Maya

doi:10.1111/ctr.12684

Cited by 9 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, the prevalence of overall adenoma, advanced adenoma, and CRC among the pretransplant ESRD patients was 35.4%, 8.1%, and 0.2%, respectively. The rate of adenoma detection via colonoscopy among pretransplant ESRD patients in our study (35.4%) is higher than most reported adenoma detection rates for the general population, although there are other recent reports [23][24][25][26] of higher rates of adenomatous polyps in chronic kidney disease and ESRD patients that vary from 24% to 54%. Furthermore, the risk of CRC appears higher in solid-organ transplant patients than in the general population.…”

Section: Discussioncontrasting

confidence: 86%

“…[45][46][47][48][49][50][51][52] Previous studies have not found that dialysis vintage has a significant effect. 23,25 In our study, dialysis vintage up to 3 years was associated with increased risk of finding adenomatous polyps on screening colonoscopy, although patients on dialysis for greater than 3 years do not share the same risks (OR = 0.74; 95% CI, 0.41-1.32; P = .304). However, the sample size was small for this group (n = 61).…”

Section: Discussionmentioning

confidence: 49%

See 1 more Smart Citation

Untitled

Chaung

Park

et al. 2017

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Transplant centers often recommend, but not necessarily require, screening colonoscopies for people over 50 years of age in accordance with the US Preventative Services Task Force guidelines for the general population. We sought to identify risk factors affecting colonoscopy results in renal failure patients undergoing kidney transplant evaluation. Materials and Methods: We retrospectively examined patients undergoing kidney transplant evaluation from 2009 to 2012 (n = 469 patients). Comparisons were made between colonoscopy reports categorized as normal (no finding or hyperplastic polyp) or abnormal (adenomatous polyp or carcinoma). Results: Of 469 patients who met the study criteria, 303 (64.6%) had normal colonoscopies and 166 (35.4%) had abnormal colonoscopies. Logistic regression analysis showed that male sex (odds ratio = 2.09; 95% confidence interval, 1.37-3.20; P = .001) and increasing age (odds ratio = 1.04; 95% confidence interval, 1.01-1.08; P = .019) were more likely to correspond to abnormal findings. Those with dialysis vintage (length of time on dialysis) up to 3 years (odds ratio = 2.10; 95% confidence interval, 1.09-4.06; P = .027) and hypertension as the cause of renal failure (odds ratio = 1.79; 95% confidence interval, 1.05-2.87; P = .002) had more abnormal findings. No differences in length of evaluation, rate of being listed for transplant, and rate of transplant were shown. Conclusions:The overall rate of adenomatous findings on colonoscopy was higher among patients with pretransplant end-stage renal disease than in the general population, as shown in other studies. Age, sex, dialysis vintage up to 3 years, and hypertensive renal failure were associated with adenomatous polyps of the colon in this study population. Because adenomatous polyp rates are high in patients with chronic kidney disease who are undergoing transplant evaluation and colonoscopic findings do not appear to delay transplant evaluations or listing rates, screening colonoscopies should be encouraged.

show abstract

Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 49%

Untitled

Chaung

Park

et al. 2017

Exp Clin Transplant

View full text Add to dashboard Cite

show abstract

“…3 In the case of colon cancer screening, the prevalence of colonic polyps in kidney transplant candidates ranges from 24% to 69%. [48][49][50] Within the general population, among people aged 50-54 y, the prevalence of colorectal adenoma is approximately 15% in women and 25% in men. At age 70-74 y, the prevalence in men rises to 39%.…”

Section: Pretransplant Recipient Screeningmentioning

confidence: 99%

Cancer Screening in Solid Organ Transplant Recipients: A Focus on Screening Liver, Lung, and Kidney Recipients for Cancers Related to the Transplanted Organ

et al. 2021

View full text Add to dashboard Cite

Over the last few decades, the life expectancy of solid organ transplant recipients (SOTRs) has improved significantly. With SOTRs living longer, more recipients are dying from cancer. There is a reported 2-to 3-fold increased risk of cancer-specific mortality in SOTRs compared with the general population. Cancer in an SOTR can be de novo, recurrent, or donor-derived. Cancer screening in this population is crucial, as early detection and treatment may improve outcomes. In the absence of randomized controlled trials dedicated to SOTRs, clinicians rely on clinical practice guidelines from regional and national transplant societies; however, these may vary considerably across jurisdictions and transplanted organ. At present, no widely accepted consensus exists for cancer screening protocols in SOTRs, particularly with regard to screening for malignancy related to transplanted organ. Some SOTRs may be at higher risk of malignancies within the allograft. This is particularly the case in lung and liver recipients, though less common in kidney recipients who are at increased risk of developing renal cell cancer in their native kidneys. This increased risk has not been uniformly incorporated into screening recommendations for SOTRs. In this review, we summarize the cancer screening recommendations for SOTRs from various transplant organizations based on transplanted organ. This review also discusses the complexity and controversies surrounding screening of cancer in the allograft and future avenues to improve cancer detection in this context. More studies specific to SOTRs are required to form generalizable and evidence-based cancer screening guidelines, particularly with respect to cancer screening in the allograft.

show abstract

“…The increased plasma levels of p-C, p-CS and IS in CKD patients exert a variety of detrimental effects, including cell damage, chronic systemic and local inflammation, coagulation disorders, immunosuppression, and intestinal permeability alterations [ 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…An up to two-fold increase in the incidence of colon cancer (CRC) has been reported in patients with severe CKD [ 14 ]. A study conducted on a population of patients on maintenance hemodialysis undergoing a screening colonoscopy showed a significantly higher prevalence of adenomatous polyps and advanced adenomas compared to the general population [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Possible Effects of Uremic Toxins p-Cresol, Indoxyl Sulfate, p-Cresyl Sulfate on the Development and Progression of Colon Cancer in Patients with Chronic Renal Failure

Paola

Izhar

et al. 2023

Genes

View full text Add to dashboard Cite

Chronic kidney disease (CKD) induces several systemic effects, including the accumulation and production of uremic toxins responsible for the activation of various harmful processes. Gut dysbiosis has been widely described in CKD patients, even in the early stages of the disease. The abundant discharge of urea and other waste substances into the gut favors the selection of an altered intestinal microbiota in CKD patients. The prevalence of bacteria with fermentative activity leads to the release and accumulation in the gut and in the blood of several substances, such as p-Cresol (p-C), Indoxyl Sulfate (IS) and p-Cresyl Sulfate (p-CS). Since these metabolites are normally eliminated in the urine, they tend to accumulate in the blood of CKD patients proportionally to renal impairment. P-CS, IS and p-C play a fundamental role in the activation of various pro-tumorigenic processes, such as chronic systemic inflammation, the increase in the production of free radicals and immune dysfunction. An up to two-fold increase in the incidence of colon cancer development in CKD has been reported in several studies, although the pathogenic mechanisms explaining this compelling association have not yet been described. Based on our literature review, it appears likely the hypothesis of a role of p-C, IS and p-CS in colon cancer development and progression in CKD patients.

show abstract

High prevalence of colon adenomas in end‐stage kidney disease patients on hemodialysis undergoing renal transplant evaluation

Cited by 9 publications

References 23 publications

Untitled

Untitled

Cancer Screening in Solid Organ Transplant Recipients: A Focus on Screening Liver, Lung, and Kidney Recipients for Cancers Related to the Transplanted Organ

Possible Effects of Uremic Toxins p-Cresol, Indoxyl Sulfate, p-Cresyl Sulfate on the Development and Progression of Colon Cancer in Patients with Chronic Renal Failure

Contact Info

Product

Resources

About