The prevalence of end-stage renal disease is increasing worldwide. Malignancies accompanying end-stage renal disease are detected in approximately 120 individuals per 10,000 person-years. Most studies have suggested that end-stage renal disease causes carcinogenesis and promotes tumor development; however, this theory remains questionable. Contrary to the theory that end-stage renal disease is predominantly carcinogenic, recent findings have suggested that after controlling for biases and sampling errors, the overall cancer risk in patients with end-stage renal disease might be lower than that in the general population, except for renal and urothelial cancer risks. Additionally, mortality rates associated with most cancers are lower in patients with end-stage renal disease than in the general population. Several biological mechanisms have been proposed to explain the anticancer effects of end-stage renal disease, including premature aging and senescence, enhanced cancer immunity, uremic tumoricidal effects, hormonal and metabolic changes, and dialysis therapy-related factors. Despite common beliefs that end-stage renal disease exacerbates cancer risk, emerging evidence suggests potential tumor-suppressive effects. This review highlights the potential anticancer effects of end-stage renal disease, proposing reconsideration of the hypothesis that end-stage renal disease promotes cancer development and progression.
终末期肾病的患病率在全球范围内呈上升趋势。终末期肾病合并恶性肿瘤的检出率约为每万人年120例。多数研究认为终末期肾病具有致癌作用并促进肿瘤发展，但这一观点仍存争议。与终末期肾病主要致癌的传统观点相反，最新研究显示在控制偏倚和抽样误差后，除肾脏及尿路上皮癌风险外，终末期肾病患者的总体癌症风险可能低于普通人群。此外，终末期肾病患者多数癌症相关死亡率也低于普通人群。目前已有多种生物学机制被提出以解释终末期肾病的抗癌效应，包括早衰与细胞衰老、增强的癌症免疫、尿毒症肿瘤杀伤效应、激素与代谢改变以及透析治疗相关因素。尽管普遍认为终末期肾病会增加癌症风险，但新证据表明其可能具有肿瘤抑制作用。本综述重点探讨终末期肾病潜在的抗癌效应，建议重新审视终末期肾病促进癌症发生发展的假说。
Is End-Stage Renal Disease Tumor Suppressive? Dispelling the Myths
肿瘤(癌症)患者之家