| Summary: | 碩士 === 國立嘉義大學 === 管院碩士在職專班 === 99 === This study used the universal insurance claims data to investigate the risk of urothelial transitional cell carcinoma (TCC) for patients with hemodialysis (HD).
This study followed 2,689 new patients with end-stage renal disease (ESRD) undergoing maintenance HD and 21,449 patients without HD identified from claims data of National Health Insurance in 2000-2002 to the end of 2007. Incidence densities of TCC in upper urinary tract (UUT) and bladder only were estimated for these two cohorts. Hazard ratios (HRs) of TCC were measured in association with HD, covariates and comorbidities.
Incidences of urothelial carcinoma were significantly higher in patients of HD cohort than that of the reference cohort for both UUT with or without concomitant bladder TCC (21.8 versus 0.65 per 10,000 person-years) and bladder TCC only (17.7 versus 3.55 per 10,000 person-years). The multivariate Cox proportional hazard regression analysis showed that the HRs of TCC in HD cohort was 33.3 for UUT (95% CI = 15.9 - 69.5) and 5.14 for bladder (95% CI = 3.24 - 8.15). Comorbidities of hematuria, urinary tract infection and hydronephrosis interact with HD for the hazards of TCC.
In summary, ESRD patients undergoing HD therapy are at high risk of developing TCC, the risk is much greater for the carcinoma of UUT than that of urinary bladder while bladder TCC is the most common urothelial cancer among general population.
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