Chronic kidney disease in patients with renal cell carcinoma.

Renal cell carcinoma (RCC) is diagnosed in over 65,000 Americans annually, and earlier detection and advances in surgical techniques have resulted in improved oncological outcomes. Given that diabetes and hypertension are independent risk factors for the development of RCC, it is not surprising that diabetic nephropathy or hypertensive nephrosclerosis are commonly encountered in these patients. Data support that at least one third of the 300,000 kidney cancer survivors in the United States have or will develop CKD; however, the effect of CKD in this clinical setting has largely evaded the attention of the medical community. It is likely that CKD which develops from postsurgical therapy for RCC may limit long-term outcomes by increasing the risk for cardiovascular morbidity and mortality. To further improve the clinical outcomes for kidney cancer patients, better recognition and management of CKD, which requires coordination among urologists, pathologists, and nephrologists, will be essential.