RCC Prevalence 'Surprisingly High' in ADPKD Patients

Patients with autosomal dominant polycystic kidney disease (ADPKD) have a “surprisingly high” prevalence of renal cell carcinoma (RCC), researchers reported online in  Nephron Clinical Practice.

Cordula Jilg, MD, of Albert Ludwigs University in Freiburg, Germany, and colleagues conducted a retrospective analysis of patients diagnosed with renal neoplasias from 1988 to 2011 using the Else Kröner-Fresenius registry. They identified 240 ADPKD patients who had undergone 301 renal surgeries. They found malignant or benign lesions in 17 patients, of whom 10 had dialysis over a mean 43 months prior to surgery. Sixteen malignant renal lesions (15 RCCs) were found in 12 of these patients. Of the 12s, eight had undergone dialysis prior to surgery.

The 16 lesions included 10 (63%) papillary RCC, five (31%) clear cell RCC, and one (6%) papillary noninvasive urothelial cancer.

The researchers said the kidney-related prevalence of RCC in ADPKD kidneys was “surprisingly high.”

“Whether or not this is due to chronic dialysis or due to the underlying disease is still speculative. Like other cystic renal diseases with an increased risk for RCC, the attending physician should be aware of the malignant potential of ADPKD, especially with concomitant dialysis.”

Previous studies have shown that patients on long-term dialysis experience a higher average annual incidence of RCC than the general population, Dr. Jilg's team noted. They pointed out that 10 of the 17 patients with malignant or benign lesions had dialysis over a mean 43 months, so “the effect of chronic dialysis on increased prevalence of RCC in those kidneys is undoubtedly present in our cohort.”

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