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Renin-producing renal cell carcinoma.

J Steffens1, R Bock, H U Braedel

  • 1Urology Department, University of Saarland, Homburg, FRG.

European Urology
|January 1, 1990
PubMed
Summary

Renin-producing renal cell carcinomas can cause hypertension. In a study, 4 out of 15 hypertensive patients with renal tumors showed primary reninism, with blood pressure normalizing after nephrectomy.

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Area of Science:

  • Nephrology
  • Oncology
  • Endocrinology

Background:

  • Hypertension is a common comorbidity in patients with renal cell carcinoma.
  • The role of renal tumors in causing hypertension is not fully understood.
  • Primary reninism, a condition characterized by excessive renin production, can lead to secondary hypertension.

Purpose of the Study:

  • To investigate the pathogenetic relationship between renal cell carcinoma and hypertension.
  • To determine the prevalence of primary reninism in hypertensive patients with renal tumors.
  • To assess the effect of nephrectomy on blood pressure in these patients.

Main Methods:

  • Studied 40 patients with renal cell carcinoma, focusing on 15 who were hypertensive.
  • Measured plasma renin activity in renal veins and renin content in tumor tissue.

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  • Utilized immunocytochemistry to detect renin in tumor tissue.
  • Monitored blood pressure changes following nephrectomy.

    • Main Results:

    • Four out of 15 hypertensive patients (26.7%) with renal tumors had primary reninism.
    • These four patients exhibited a high tumor kidney to contralateral kidney ratio of plasma renin activity (6-7).
    • Renin content was significantly higher in tumor tissue compared to adjacent normal renal cortex; immunocytochemical renin was detected in these tumors.
    • Three patients experienced normalization of blood pressure post-nephrectomy, and one showed a significant drop.

    Conclusions:

    • Renin-producing renal cell carcinomas are an uncommon but significant cause of renal hypertension.
    • Primary reninism associated with renal tumors should be considered in the differential diagnosis of hypertension.
    • Nephrectomy can be an effective treatment for hypertension caused by renin-producing renal cell carcinomas.