Membranous nephropathy complicated by renal cell carcinoma

Renal cell carcinoma (RCC) is one of the most common kidney malignancies. An upgraded comprehension of the molecular biology implicated in the development of cancer has stimulated an increase in research and development of innovative antitumor therapies. The aim of the study was to analyze the medical literature for hypertension and renal toxicities as the adverse events of the vascular endothelial growth factor (VEGF) signaling pathway inhibitor (anti-VEGF) therapy. Relevant studies were identified in PubMed and ClinicalTrials.gov databases. Eligible studies were phase III and IV prospective clinical trials, meta-analyses and retrospective studies that had described events of hypertension or nephrotoxicity for patients who received anti-VEGF therapy. A total of 48 studies were included in the systematic review. The incidence of any grade hypertension ranged from 17% to 49.6%. Proteinuria and increased creatinine levels were ascertained in 8% to 73% and 5% to 65.6% of patients, respectively. These adverse events are most often mild in severity but may sometimes lead to treatment discontinuation. Nephrotoxicity and hypertension are related to multiple mechanisms; however, one of the main disturbances in those patients is VEGF inhibition. There is a significant risk of developing hypertension and renal dysfunction among patients receiving anti-VEGF treatment; however, there is also some evidence that these side effects may be used as biomarkers of response to antiangiogenic agents.

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“…RCC patients may develop IgA nephropathy, FSGS and membranous nephropathy as a paraneoplastic syndrome [73,74]. …”

Section: Discussionmentioning

confidence: 99%

Influence of Tyrosine Kinase Inhibitors on Hypertension and Nephrotoxicity in Metastatic Renal Cell Cancer Patients

Semeniuk-Wojtaś

Lubas

Stec

et al. 2016

IJMS

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“…Since membranous nephropathy associated with malignancy has been attributed to tumor antigen-antibody immune complex formation, the cancer related antigens have been identified in immune complex in some cases including PSA in prostate cancer, CEA in gastrointestinal cancer [34]. Renal cell carcinoma has been reported to be associated with membranous nephropathy [35][36][37][38][39][40][41][42][43], but its prevalence is lower compared with gastrointestinal cancer and lung cancer (Table 3). As antibodies against phospholipase A2 receptor antibody have been identified in 70 % of patients with primary membranous nephropathy [44], a diagnosis of secondary membranous nephropathy should be considered when it is negative.…”

Section: Membranous Nephropathy and Renal Cell Carcinomamentioning

confidence: 99%

Paraneoplastic Glomerulopathy Associated with Renal Cell Carcinoma

Tojo¹

2013

Renal Tumor

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Figure . However, when VHL protein is lost in clear cell renal cell carcinoma, various cytokines and growth factors induced by HIFare enhanced vascular endothelial growth factor VEGF which stimulates angiogenesis of carcinoma, platelet-derived growth factor PDGF and transforming growth factor alpha TGF-, which lead to tumor growth, glucose transporter GLUT-and carbonic anhydrase IX CA IX , which leads to tumor cell survival in an acidic environment [ -]. NF-kB activity is also regulated by VHL protein, and cytokine-inducible transcription factors including NF-kB and STAT are activated in renal cell carcinoma [ -]. Renal cell carcinoma tissue and cell lines of the tumor express mRNA of IL-and IL-receptor [ , ], which may play a role in cancer cell growth in an autocrine or paracrine manner. Renal Tumor

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