Renal Cystic Diseases and Renal Neoplasms

Bonsib, Stephen M.

doi:10.2215/cjn.02020309

Cited by 105 publications

(84 citation statements)

References 99 publications

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“…Perhaps the most important risk factor is acquired polycystic kidney disease, a condition that develops in people with CKD and decreases in prevalence following kidney transplantation. 22 Acquired polycystic kidney disease is associated with an elevated risk of kidney cancer, 23,24 particularly localized stage cancer, 22 which may explain why the changes in kidney cancer risk in our study were limited to localized cancers. It has been hypothesized that the association of thyroid cancer with ESRD could be a result of metabolic dysfunction arising with kidney failure.…”

Section: Discussionmentioning

confidence: 82%

Variation in Cancer Incidence among Patients with ESRD during Kidney Function and Nonfunction Intervals

Yanik

Clarke

Snyder

et al. 2015

JASN

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Among patients with ESRD, cancer risk is affected by kidney dysfunction and by immunosuppression after transplant. Assessing patterns across periods of dialysis and kidney transplantation may inform cancer etiology. We evaluated 202,195 kidney transplant candidates and recipients from a linkage between the Scientific Registry of Transplant Recipients and cancer registries, and compared incidence in kidney function intervals (time with a transplant) with incidence in nonfunction intervals (waitlist or time after transplant failure), adjusting for demographic factors. Incidence of infection-related and immune-related cancer was higher during kidney function intervals than during nonfunction intervals. Incidence was most elevated for Kaposi sarcoma (hazard ratio [HR], 9.1; 95% confidence interval (95% CI), 4.7 to 18), nonHodgkin's lymphoma (HR, 3.2; 95% CI, 2.8 to 3.7), Hodgkin's lymphoma (HR, 3.0; 95% CI, 1.7 to 5.3), lip cancer (HR, 3.4; 95% CI, 2.0 to 6.0), and nonepithelial skin cancers (HR, 3.8; 95% CI, 2.5 to 5.8). Conversely, ESRD-related cancer incidence was lower during kidney function intervals (kidney cancer: HR, 0.8; 95% CI, 0.7 to 0.8 and thyroid cancer: HR, 0.7; 95% CI, 0.6 to 0.8). With each successive interval, incidence changed in alternating directions for non-Hodgkin's lymphoma, melanoma, and lung, pancreatic, and nonepithelial skin cancers (higher during function intervals), and kidney and thyroid cancers (higher during nonfunction intervals). For many cancers, incidence remained higher than in the general population across all intervals. These data indicate strong short-term effects of kidney dysfunction and immunosuppression on cancer incidence in patients with ESRD, suggesting a need for persistent cancer screening and prevention.

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Section: Discussionmentioning

confidence: 82%

Variation in Cancer Incidence among Patients with ESRD during Kidney Function and Nonfunction Intervals

Yanik

Clarke

Snyder

et al. 2015

JASN

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“…In addition, 18 FDG uptake is not specific for infection and may be increased in other conditions, like tumors. The actual risk of malignancy in AD-PKD patients does not seem to be increased (22). Liver cystadenocarcinomas are uncommon, and most kidney tumors show low-grade malignancy leading to low 18 FDG uptake (14).…”

Section: Discussionmentioning

confidence: 99%

Positron-Emission Computed Tomography in Cyst Infection Diagnosis in Patients with Autosomal Dominant Polycystic Kidney Disease

Jouret

Lhommel²,

Beguin³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground Cyst infection remains a challenging issue in patients with autosomal dominant polycystic kidney disease (ADPKD). In most patients, conventional imaging techniques are inconclusive. Isolated observations suggest that 18 fluorodeoxyglucose ( 18 FDG) positron-emission computed tomography (PET/CT) might help detect cyst infection in ADPKD patients.Design, setting, participants, & measurements Comparative assessment of administrative databases from January 2005 to December 2009 identified 27 PET/CT scans performed in 24 ADPKD patients for suspicion of abdominal infection. Cyst infection was definite if confirmed by cyst fluid analysis. Cyst infection was probable if all four of the following criteria were met: temperature of Ͼ38°C for Ͼ3 days, loin or liver tenderness, C-reactive protein plasma level of Ͼ5 mg/dl, and no CT evidence for intracystic bleeding. Episodes with only two or three criteria were grouped as "fever of unknown origin".Results Thirteen infectious events in 11 patients met all criteria for kidney (n ϭ 3) or liver (n ϭ 10) cyst infection. CT was contributive in only one patient, whereas PET/CT proved cyst infection in 11 patients (84.6%). In addition, 14 episodes of "fever of unknown origin" in 13 patients were recorded. PET/CT identified the source of infection in nine patients (64.3%), including 2 renal cyst infections. Conversely, PET/CT showed no abnormal 18 FDG uptake in 5 patients, including 2 intracystic bleeding. The median delay between the onset of symptoms and PET/CT procedure was 9 days.Conclusions This retrospective series underscores the usefulness of PET/CT to confirm and locate cyst infection and identify alternative sources of abdominal infection in ADPKD patients.

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“…An imbalance favoring proliferation over apoptosis contributes to the development of cysts, epithelial hyperplasia, and microscopic adenomas in PKD (91,92), but enhanced apoptosis may be sufficient to reduce the risk for development of renal cell carcinoma (93). Recent data indicate that further enhancement of apoptosis within cyst linings in a Pkd1 model is of value in decreasing cystogenesis (94).…”

Section: Figurementioning

confidence: 99%

Genetic mechanisms and signaling pathways in autosomal dominant polycystic kidney disease

2014

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Recent advances in defining the genetic mechanisms of disease causation and modification in autosomal dominant polycystic kidney disease (ADPKD) have helped to explain some extreme disease manifestations and other phenotypic variability. Studies of the ADPKD proteins, polycystin-1 and -2, and the development and characterization of animal models that better mimic the human disease, have also helped us to understand pathogenesis and facilitated treatment evaluation. In addition, an improved understanding of aberrant downstream pathways in ADPKD, such as proliferation/secretion-related signaling, energy metabolism, and activated macrophages, in which cAMP and calcium changes may play a role, is leading to the identification of therapeutic targets. Finally, results from recent and ongoing preclinical and clinical trials are greatly improving the prospects for available, effective ADPKD treatments.

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Renal Cystic Diseases and Renal Neoplasms

Cited by 105 publications

References 99 publications

Variation in Cancer Incidence among Patients with ESRD during Kidney Function and Nonfunction Intervals

Variation in Cancer Incidence among Patients with ESRD during Kidney Function and Nonfunction Intervals

Positron-Emission Computed Tomography in Cyst Infection Diagnosis in Patients with Autosomal Dominant Polycystic Kidney Disease

Genetic mechanisms and signaling pathways in autosomal dominant polycystic kidney disease

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