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- Almgren, Torbjörn, 1959, et al.
(författare)
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Reninom – en ovanlig men botbar orsak till sekundär hypertoni
- 2023
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Ingår i: Lakartidningen. - 1652-7518. ; 120
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Tidskriftsartikel (refereegranskat)abstract
- Reninoma - rare juxtaglomerular tumor associated with hypertension We present a case study of two female patients, aged 20-30 years, who were diagnosed with reninoma, a rare juxtaglomerular tumor associated with hypertension, high plasma renin and hypokalemia. Both patients were referred to the Department of Internal Medicine at Sahlgrenska University Hospital, but their cases were ten years apart. In both instances, the renin-secreting tumor was surgically removed, resulting in the normalization of blood pressure without the need for antihypertensive medication. Based on our findings, we recommend physicians interested in hypertension to analyze plasma renin levels before starting antihypertensive treatment in young patients. Additionally, we suggest performing an MRI of the kidneys followed by renal vein catheterization, which can confirm but not exclude the presence of a reninoma. It is important to note that treatment with RAAS (renin-angiotensin-aldosterone system) blockers may mask the effects of reninoma on blood pressure and potassium levels. Since RAAS blockers are contraindicated during pregnancy, it is of particular importance to diagnose reninoma in young women of childbearing age.
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| 2. |
- Ljungberg, Börje, 1949-, et al.
(författare)
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Local recurrence after nephron-sparing therapy in Sweden, a register based study
- 2019
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 53, s. 27-28
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: In the Swedish Kidney Cancer Registry 99% of all patients nationwide are reported. The aim of this study is to present results of occurrence of recurrences in the treated kidney after nephron sparing treatments in patients with T1aN0M0 renal cell carcinoma (RCC) and their overall survival.Material: Since 2005 around 14.000 patients have been included prospectively in the National Swedish Kidney Cancer Register. Among those patients there were 5013 out of 5311 patients (94%) without metastatic disease that had a follow-up checkup 5 years after diagnosis. Among the 5013 patients, 39 had unclear recurrence data and were excluded from the analysis. Statistical analysis was done by SPSS 24. SCANDINAVIAN JOURNAL OF UROLOGY 27Results: In total, 1015 (19.9%) had recurrent disease during 5 years follow-up. During the time of diagnosis (2005 -2012,) 1077 patients were treated with nephron sparing treatment: 947 with partial nephrectomy (PN), 114 with radiofrequency ablation (RF) and 16 with other treatments. Among pT1a patients 16 of 712 treated with PN (1.7%) had a local recurrence compared with 13 of 105, (12.3%) RF patients. PN Patients had significantly better overall survival than RF patients. However RF patients were significantly older than PN (67.7 vs 60.6 years, p< 0.0001). Also tumor size was larger in PN (27.3 VS 24.4 MM, P< 0.001) as well as longer follow-up-time 8.1 versus 7.1 years. All PNs had a verified histology while only 97 out of 114 tumors treated with RF had a verified histology (85%).Conclusion: Conclusions. In this population-based study, 19.9% with M0 disease recurred within 5 years. Patients with T1a tumors treated with RF had significantly more frequently local recurrence than PN patients. Furthermore, patients with RF treatment had a significantly shorter overall survival but were older. In contrast, patients treated with PN had larger tumors, had longer follow-up time and were all histology proven. The significance of these observations might be important.
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| 3. |
- Lund, Lars, et al.
(författare)
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Use of venous-thrombotic-embolic prophylaxis in patients undergoing surgery for renal tumors : a questionnaire survey in the Nordic countries (The NORENCA-2 study)
- 2018
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Ingår i: Research and Reports in Urology. - : DOVE Medical Press Ltd.. - 2253-2447. ; 10, s. 181-187
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine the variation in venous thromboembolism prophylactic treatment (VTEP) among renal cancer patients undergoing surgery.Materials and methods: An Internet-based questionnaire on renal tumor management before and after surgery was mailed to all Nordic departments of urology. The questions focused on the use of VTEP and were subdivided into different surgical modalities.Results: Questionnaires were mailed to 91 institutions (response rate 53%). None of the centers used VTEP before surgery, unless the patient had a vena caval tumor thrombus. Overall, the VTEP utilized during hospitalization for patients undergoing renal surgery included early mobilization (45%), compression stockings (52%) and low-molecular-weight heparin (89%). In patients undergoing open radical Nx, 80% of institutions used VTEP during their hospitalization (23% compression stockings and 94% low-molecular-weight heparin). After leaving the hospital, the proportion and type of VTEP received varied considerably across institutions. The most common interval, used in 60% of the institutions, was for a period of 4 weeks. The restriction to the Nordic countries was a limitation and, therefore, may not reflect the practice patterns elsewhere. It is a survey study and, therefore, cannot measure the behaviors of those institutions that did not participate.Conclusion: We found variation in the type and duration of VTEP use for each type of local intervention for renal cancer. These widely disparate variations in care strongly argue for the establishment of national and international guidelines regarding VTEP in renal surgery.
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| 4. |
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| 5. |
- Lund, Lars, et al.
(författare)
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Use of venous-thrombotic-embolic (vte) prophylaxis in patients undergoing surgery for renal tumors in Nordic countries (the Norenca-II study)
- 2017
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 51:Suppl. 220, s. 48-48
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Development of venous thromboembolism (VTE) is due to a homeostatic imbalance in the interaction between the vessel wall, flow and blood composition. Reduced flow is a wellknown risk factor for VTE. Cancer patients often have reduced flow, particularly associated with prolonged immobilization or by direct compression of the veins by a growing tumor.Objectives: The purpose of the study is to examine whether renal cancer patients in the five Nordic countries undergoing surgery receive VTE prophylactic treatment (VTEP).Methods: A 21-question internet based questionnaire on renal tumor management before and after surgery was mailed to all Nordic departments performing renal cancer surgery. The questions were subdivided into the different surgical modalities and the use of VTEP. Descriptive statistics were performed.Results: The questionnaires were posted to 91 institutions of which 6 did not perform renal surgery in 2016. We received responses from 45 of 85 hospitals performing renal surgery (response rate 53%). None of the centers used VTEP before surgery unless the patient had a vena caval tumor thrombus. Overall, VTEP in the hospital for patients undergoing renal surgery included 47% using early mobilization, 53% compression stocking and 88% low molecular weight heparin (LMWH). In patients undergoing open radical or partial Nx, 79% received VTEP (24% compression stockings, 2% subcutaneous heparin and 94% LMWH). After leaving the hospital the proportion of patients received VTEP for differing periods (6% for one week, 35% for 2 weeks, and 59% for four weeks). In patients undergoing robotic radical Nx 19% received VTEP for one week, 44% for 2 weeks and 37% for 4 weeks. For those who underwent Lap/robotic partial Nx, 69% received VTEP. In these, in total 30% had compression stockings, 10% subcutaneous heparin and 87% received LMWH. VTEP was continued for one week, 2 weeks and four weeks for 20%, 50% and 30% of the patients respectively. Five centers performed lap/robotic thermal ablation of tumors and overall 57% used compression stockings and 71% LMWH. Two centers continued VTEP for one week (40%) and three for 2 weeks (60%). Two centers performed percutaneous ablation.Conclusion: We found differences in duration of VTEP use by type of operation and across differing facilities. Given the highly varied approach to VTEP, the presented data suggests a need for national and international guidelines to help reduce the variations in care regarding VTE prophylaxis in renal surgery.
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| 6. |
- Nisen, Harry, et al.
(författare)
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Contemporary treatment of renal tumors : a questionnaire survey in the Nordic countries (the NORENCA-I study)
- 2017
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 51:5, s. 360-366
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The five Nordic countries comprise 25 million people, and have similar treatment traditions and healthcare systems. To take advantage of these similarities, a collaborative group (Nordic Renal Cancer Group, NORENCA) was founded in 2015.MATERIALS AND METHODS: A questionnaire of 17 questions on renal tumor management and surgical education was designed and sent to 91 institutions performing renal tumor surgery in 2015. The response rate was 68% (62 hospitals), including 28 academic, 25 central and nine district hospitals. Hospital volume was defined as low (LVH: < 20 operations), intermediate (IVH: 20-49 operations), high (HVH: 50-99) and very high (VHVH: ≥ 100). Descriptive statistics were performed.RESULTS: Fifteen centers were LVH, 16 IVH, 21 HVH and 10 VHVH. Of all 3828 kidney tumor treatments, 55% were radical nephrectomies (RNs), 37% partial nephrectomies (PNs) and 8% thermoablations. For RN and PN, the percentages of open, laparoscopic and robotic approaches were 47%, 40%, 13% and 47%, 20%, 33%, respectively. The mean complication rate (Clavien-Dindo 3-5) was 4.9%, and 30 day mortality (TDM) was 0.5%. The median length of hospital stay was 4 days. Training with a simulator, black box or animal laboratory was possible in 48%, 74% and 21% of institutions, respectively.CONCLUSIONS: Despite some differences between countries, the data suggest an overall general common Nordic treatment attitude for renal tumors. Furthermore, the data demonstrate high adherence to international standards, with a high proportion of PN and acceptable rates for major complications and TDM.
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