Introduction:
Cancer of the cervix is one of the leading causes of cancer death among women worldwide. 79 % of new cancer cervix cases occur in developing countries. Incidence in India is about 32 per 100,000 women and it is most common female cancer in developing countries. Over 70 % of case present in advanced stages with poor prognosis and high mortality rate. The differential pattern of cervical cancer and the wide variation in incidence are possibly related to environmental factors. About 70% of them present as locally advanced disease, and one-third of them with renal failure. Such patients have poor prognosis and are usually managed with palliative radiation or best supportive care. Kidney disease frequently complicates malignancy and its treatment. The spectrum of disease in this setting includes acute kidney injury, chronic renal failure, and tubular disorders. These complications are often preventable or reversible with prompt and early diagnosis and treatment.
Methods:
The study included 174 patients of carcinoma cervix referred to nephrology department, Gandhi hospital with renal dysfunction between January 2016 to September 2023.
Results:
It was observed that mean age of the patients was 54 ± 2 years.
Clinical renal disease presentation like Anuria/oliguria observed in 154 (88.5 %) patients, pedal edema 60 (34.4 %) shortness of breath in 62(35.6%). Comorbidities like Diabetes in 46(26.4%) patients, HTN in 54(31.03%) patients observed.
Hydroureteronephrosis seen in 157 cases, Sepsis related AKI seen in 7 patients
,5 cases were ESRD, BOO with HDUN seen in 6 cases. Denovo Carcinoma cervix was seen in 87 patients while recurrence was seen in 77 patients.
Mean serum creatinine at presentation was 9 ± 2.2 mg/dl. PCN was done in 94 patients, DJS + PCN done in 38 patients, Urethral dilatation done in 16 patients while 7 patients received broad spectrum antibiotics. 34 patients received Radiotherapy while 88 received combined CT and RT. 28 patients has history of hysterectomy. 138 patients received HD,12 patients underwent PD.
Average duration of HD done was 7 ± 2 days. Complete renal recovery seen in 116 patients, partial recovery seen in 36 patients ,6 patients were dialysis dependent. Average duration of Renal recovery was 12 ± 2 days. 28 patients died during study. Out of 106 patients who underwent cervical biopsy 83 had squamous cell carcinoma, 23 had stump cell carcinoma.
Conclusions:
The overall prognosis is poor in patients requiring haemodialysis and high mortality rate in carcinoma cervix with renal failure patients.
Aggressive management with an initial ureteric diversion will be curative in some cases who report early in the course of renal failure.
Early diagnosis of disease is required for good prognosis of patients.
High creatinine at the time of presentation has poor outcome.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.