Prevalence of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease and chronic renal failure

Urology. 2009 Sep;74(3):631-4. doi: 10.1016/j.urology.2009.02.078. Epub 2009 Jul 18.

Abstract

Objectives: To study the prevalence and the characteristics of renal cell carcinoma (RCC) in patients with autosomal dominant polycystic kidney disease (ADPKD) in our series.

Methods: We reviewed retrospectively all the nephrectomies performed in our department between 1982 and 2003 in patients with ADPKD and chronic renal failure.

Results: Seventy-nine patients (42 males and 37 females) with ADPKD and chronic renal failure underwent 89 nephrectomies; in 10 of 79, both kidneys were removed but not simultaneously. Mean age was 50.4 years (range, 32-69 years). Of 79 patients, 50 had end-stage renal disease (ESRD) and were on hemodialysis or had received a transplant for >1 year. On histologic examination, 11 of 89 kidneys were diagnosed with carcinomas. There was 1 patient with bilateral tumor (tubulopapillary Ca) and 3 kidneys (27.3%) with multifocal tumors. Regarding the histologic type, there were 7 of 12 (58.3%) clear cell carcinomas and the remaining 5 (41.7%) were tubulopapillary carcinomas.

Conclusions: The prevalence of RCC was higher in patients with ADPKD and ESRD, with >1 year on dialysis or renal transplantation undergoing nephrectomy according the protocol. It would be 2 to 3 times more frequent than RCC in patients with ESRD alone. The clinician should maintain a high alert of suspicion for RCC in such patients.

MeSH terms

  • Carcinoma, Renal Cell / complications*
  • Carcinoma, Renal Cell / epidemiology*
  • Carcinoma, Renal Cell / surgery
  • Female
  • Humans
  • Kidney Failure, Chronic / complications*
  • Kidney Neoplasms / complications*
  • Kidney Neoplasms / epidemiology*
  • Kidney Neoplasms / surgery
  • Male
  • Middle Aged
  • Polycystic Kidney, Autosomal Dominant / complications*
  • Polycystic Kidney, Autosomal Dominant / surgery
  • Prevalence
  • Retrospective Studies