Objective:To analyze the incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis.Methods:Clinical data of 627 hemodialysis patients in Huadu District People′s Hospital of Guangzhou who met the inclusion criteria and exclusion criteria from January 2015 to December 2020 were retrospectively collected. Clinical characteristic of patients with malignant tumors was summarized. Multivariate logistics regression analysis was performed to explore the related factors of malignant tumors.Results:Among the 627 patients, 19(3.03%) developed malignant tumors. There were 14 males and 5 females with a mean age of (65.7±13.7)years. Their mean dialysis duration was (45.16±38.18)months. Gastrointestinal tumor was the most common tumor type (9/19). Univariate analysis showed that the age of the patients combined with malignant tumors was significantly higher, and the serum prealbumin was significantly lower than those patients without malignant tumors (all P<0.05). Logistic regression analysis showed that age was the independent risk factor of developing cancers after adjusting dialysis age, hemoglobin, albumin and parathyroid hormone ( P<0.05). Conclusions:The incidence of malignant tumor is significantly higher in maintenance hemodialysis patients than that in the general population. Age is the risk independent risk factor. Therefore, we should strengthen the monitoring of elderly hemodialysis patients, discover the disease in time, and take measures to improve the prognosis.

Objective Contrast-induced nephropathy (CIN) is the third leading cause of inhospital acute renal failure.Angiotensin conversing enzyme inhibitor(ACEI) and angiotensin Ⅱ receptor blocker(ARB) are commonly used to treat hypertension,heart falure and diabetic nephropathy.However,the role of ACEI and ARB in CIN is controversial.Our aim is to conduct a meta-analysis of these trials to assess the relationship between ACEI or ARB and CIN.Methods We performed a literature search of PubMed,Cochrane library,Web of Science using the keywords about Renin Angiotensin System inhibitors,including the name of drugs,and contrast induced nephropathy.The primary end point is CIN.We carried out data on author,publishing year,patients characteristics,definition of CIN,complications (hypertension,diabetes,coronary heart diseases,et al),type and volume of contrast media,prevention strategies.All statistical analyses were performed using Review Manager version 5.3.Results A total of 14 trials were pooled.5 868 patients received ACEI/ARB treatment and 3 081 patients were in the control group.The incidence of CIN was 12.5％ (n =735) in ACEI/ARB group,7.9％ (n=244) in control group.The meta-analysis of 14 trials found ACEI or ARB can increase the risk of contrast-induced nephropathy (OR=1.56,95％ CI 1.06 ～ 2.31,P=0.03).In the 6 randomized controlled trials,the incidence of CIN was 9.4％ (n=38) in ACEI/ARB group,10.7％ (n=40) in control group.The meta-analysis of 6 randomized controlled trials showed that ACEI or ARB have no effect on CIN(OR=0.91,95％ CI 1.57 ～ 1.47,P=0.71).In the 6 observational studies,the incidence of CIN was 9.7％ in ACEI/ARB group,9％ in control group.The meta-analysis of 6 observational studies showed that ACEI or ARB can increase the risk of CIN(OR=2.76,95％ CI 1.82 ～4.17,P＜0.00001).Conclusions ACEI/ARB can increase the risk of CIN.