# Outcomes and complications of hemodialysis in patients with renal cancer following bilateral nephrectomy

## TL;DR

This paper examines the challenges of hemodialysis in patients with renal cancer after bilateral nephrectomy, focusing on hypotension, anemia, and tumor recurrence.

## Contribution

The study highlights the high tumor recurrence rate in elderly patients and suggests early kidney transplantation as a potential solution.

## Key findings

- Literature analysis showed a 100% tumor recurrence rate in elderly patients over 50 years.
- Anemia treatment with erythropoietin-stimulating agents and rosuvastatin improved dialysis-related hypotension and anemia.
- Hypotension and tumor recurrence are significant complications post-bilateral nephrectomy.

## Abstract

The management of patients undergoing bilateral nephrectomy for renal cancer presents significant challenges, particularly in addressing hypotension, anemia, and tumor recurrence during hemodialysis.

A patient diagnosed with renal clear cell carcinoma in 2009 was followed until his demise in June 2022, with detailed documentation of symptoms, signs, laboratory results, diagnosis, and treatment. In the presented case, post-nephrectomy, the patient experienced frequent hypotension and anemia during dialysis, improving with erythropoietin-stimulating agents and subsequently with rosuvastatin. Later, multiple metastases were detected, correlating with normalized blood pressure and hemoglobin.

A literature search up to September 2023 was also conducted, gathering data on hypotension, anemia, and tumor recurrence post-nephrectomy. Literature analysis of six cases revealed a 100% tumor recurrence rate in elderly patients (>50 years).

Treatment of anemia in bilateral nephrectomy patients warrants consideration of medication-induced tumor recurrence, highlighting early kidney transplantation to avoid adverse reactions like hypotension.