| Abstract [eng] |
While kidney transplantation is the most effective treatment for end-stage renal disease, the required long-term immunosuppressive therapy significantly increases the risk of skin cancer and precancerous lesions. The epidemiology and underlying risk factors of post-transplant skin cancer in Lithuania remain under-researched. Therefore, this study is highly relevant for improving the dermatological surveillance and skin cancer prevention strategies for transplant recipients. Aim of the study. To determine the prevalence of skin cancer and precancerous skin lesions in kidney transplant patients and to evaluate the demographic and clinical factors associated with their development, as well as patients' sun behavior habits. Objectives. 1) To determine the prevelance, anatomical localization, most common types, and time from kidney transplantation to diagnosis of skin cancer and precancerous skin lesions among kidney transplant recipients in Lithuania. 2) To evaluate the influence of demographic and clinical factors on the development of skin cancer and precancerous skin lesions among kidney transplant recipients in Lithuania. 3) To assess patients' sun behavior habits and their changes following kidney transplantation. Methods. This retrospective observational biomedical cohort study analysed data collected between January 2025 and February 2026 at the Center of Dermatovenereology, Vilnius University Hospital Santaros Klinikos. Data were sourced from physical examinations, patient questionnaires, and electronic medical records. Variables included patient demographics, transplantation history, personal and family history of skin diseases, immunosuppressive regimens, and lifestyle factors. Statistical analysis was performed using 16.106.2 bei IBM SPSS 30.0.0.0. software. Results were presented as frequencies, mean ± standard deviation, median (interquartile range) and risk ratio (95% confidence interval). A p-value of < 0.05 was considered statistically significant. Results. The study sample consisted of 73 patients: 41 male (56.2%) and 32 female (43.8%) with a mean age of 52.8 ± 11.1 years, median – 55.0 years (Q1 – Q3: 46,0 – 61,0). Skin cancer or precancerous lesions were diagnosed in 16.4% (n = 12) of patients, while invasive skin cancer was present in 12.3% (n = 9). Basal cell carcinoma was most prevalent (66.7% of all skin tumors). Statistically significant risk factors included older age (the ≥ 60 years age group was associated with a 3.47-fold increased risk (95 % PI: 1,24–9,71, p = 0.033), systemic etiology of primary kidney disease – 3.14-fold increased risk (95 % PI: 1,14–8,69, p = 0.032), and a pre-transplant history of skin cancer – 4.47-fold increased risk (95 % PI: 1,75–11,42, p = 0.030). Patients demonstrated a statistically significant improvement in their sun protection measures post transplantation (p ≤ 0.005). Conclusions. The prevalence of skin cancer following kidney transplantation is 12.3%, with basal cell carcinoma being most common. The most significant post-transplant risk factors for skin tumors are older patients‘ age, systemic primary kidney disease, and a pre-transplant history of skin cancer. UV radiation protection behaviors improved significantly following kidney transplantation. |
