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Kidney transplant recipients have increased risk of cancers when compared with the general population. Hepatocellular carcinoma (HCC) is extremely important in Asia where hepatitis B virus (HBV) infection is endemic. The aim is to study the epidemiological and clinical aspects of all de novo HCC in our kidney transplant recipients. Moreover, various preventive strategies which may help to optimize the outcome will also be discussed. A retrospective review of all patients who developed HCC after kidney transplantation between May 1972 and December 2011 in Hong Kong, based on the data from Hong Kong Renal Registry. After a follow-up period of 40,246 person-years, 20 patients (males 15: females 5) developed HCC. The annual incidence was 49.7/100,000 persons per year. Among them, 16 were HBV carriers, 2 were hepatitis C (HCV) carriers and 2 had HBV and HCV co-infection. Presence of HBV infection was associated with 78-fold higher risk for HCC development. Majority (85%) were asymptomatic when HCC was diagnosed by ultrasound or alpha-fetoprotein surveillance. All patients diagnosed by surveillance received active treatment while 2/3 of symptomatic patients could only receive symptomatic care and died rapidly. In conclusion, HBV infection is the major etiological factor for HCC development in kidney transplant recipients in HBV endemic areas. Regular HCC surveillance appeared to be able to detect early stage cancers which are amenable to treatment and offer the best hope of cure.

Manystudies have shown that kidney transplant recipients have a higher incidence of cancers when compared with general population. However, most data on the posttransplant malignancies (PTM) are derived from Western literature and large population-based studies are rare. There is also lack of information about the posttransplant cancer-specific mortality rate. We conducted a population-based study of 4895 kidney transplants between 1972 and 2011, with data from the Hong Kong Renal Registry. Patterns of cancer incidence and mortality in our kidney transplant recipients were compared with those of the general population using standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) respectively. With 40 246 person-years of follow-up, 299 PTM was diagnosed. The SIR of all cancers was 2.94 (female 3.58 and male 2.58). Non-Hodgkin lymphoma (NHL), kidney, and bladder cancers had the highest SIRs. The overall SMR was 2.3 (female 3.4 and male 1.7) and the highest SMR was NHL. The patterns of PTM differ among countries. Increases in cancer incidence can now translate into similar increases in cancer mortality. NHL is important in our kidney transplant recipients. Strategies in cancer screening in selected patient groups are needed to improve transplant outcomes.

Objectives. The purpose of this study was to evaluatethe outcome of systemic lupus erythematosus (SLE)patients on continuous ambulatory peritoneal dialysis(CAPD).Methods. Eighteen SLE patients who had been under-going CAPD for at least 3 months in our unit werecompared with 36 other age- and gender-matched non-diabetic CAPD patients with an underlying primarychronic glomerulonephritis (CGn). The clinical out-come, infective complications, lupus activities, bio-chemical parameters, haemoglobin level and the use oferythropoietin were reviewed.Results. The duration of dialysis of the two studiedgroups was not different, with a mean of 35.4 monthsfor the SLE group and 36.7 months for the CGn group.Before dialysis, SLE patients had a significantly loweralbumin level (30.4±6.6 vs 35.4±5.59g/dl, P

Diabetic muscle infarction (DMI) is a serious complication seen in patients with long-standing diabetes. Evidence is accumulating since the first description of this entity in 1965 (1). Increasing awareness has led to prompt recognition of this previously underdiagnosed condition. Typically, acute presentation with atraumatic painful swelling, notably of the quadriceps or thigh muscles, is found in diabetic subjects with established vasculopathy including retinopathy and nephropathy. Laboratory investigations generally show high erythrocyte sedimentation rate, normal white cell count, and normal or mild elevation of creatine phosphokinase. Magnetic resonance imaging (MRI) findings are invariably characterized by increased signal intensity of the diffusely enlarged muscle groups on T2-weighted sequences, inversion-recovery, and gadolinium-enhanced images (2–4). The disease is generally believed to be self-limiting, although recurrence can occur in half of the cases (4,5). We have previously reported two …