Other Renal Disorders Flashcards
What is the MC kidney cancer and when is it dx?
Renal cell carcinoma
90-95% of renal cancers
4% of cancers
60 yo MC
2x as common in men
What is the MC cause of renal cell carcinoma?
Sporadic MC
but there is familial cause
Also inactivitivty
Chronic disease causing inflammation
NSAIDs
What is the biggest risk factor for renal cell carcinoma?
Smoking
What is the MC renal cell carcinoma? What is the other cause?
75-85% are clear cell carcinomas
Arise from PT
Other cause (10-15%) is papillary tumors
also some other types
What is the MC symptom of renal cell carcinoma?
Hematuria - occurs in 50-60%
Often is brown, because it is further down
What is the classic triad of renal cell carcinoma and how common is it?
Flank pain
Hematuria
Abdominal mass
rare though
HAF the MC cancer
What is the MC way renal cell carcinoma is found?
Incidentally on renal imaging b4 symptoms
What would cough and bone pain suggest for renal cell carcinoma?
Metastis :(
seen in 20-30% on initial dx
What are the lab findings of renal cell carcinoma?
MC hematuria 60%
Anemia or erythrocytosis (from blood loss)
Hypercalcemia (metastasis)
Stauffer syndrome
What is stauffer syndrome?
Hepatic dysfunction with elevated LFTs secondary to renal cell carcinoma (not metastisis)
Why do you have anemia in renal cell carcinoma?
Losing too much blood
Can tack away tissue of kidney that makes erythropoietin
Why do you sometimes see erythrocytosis?
Differentiated cancer can retain characteristics of original tissue making erythropoietin
What is the initial imaging of renal cell carcinomas?
US (start here)
CT of abdomen and pelvis and MRI is most valuable
sometimes doppler US, bone scan, brain imaging (if AMS)
What labs should you get for renal cell cariconma?
renal function, hepatic function (abnormal = stauffer syndrome sometimes), CBC (do they have anemia), UA, urine cytology
all of these reaffirm dx, but do not confirm it
What differs the CT in polycystic kidney versus renal cell carcinoma?
Polycystic = cysts everywhere on kidney, well defined margins
RCC: bumpy margins, not as well defined
What is the treatment for an isolated renal cell carcinoma?
Surgical excision including the kidney, ipsilateral adrenal gland, and adjacent lymph nodes (in case they spread their)
-can consider partial nephrectomy
If metastatic renal cell carcinoma, what is the treatment?
Stage IV, surgery does not improve outcomes
Limited effect of chemotherapy :(
What is the 5 survival rate for renal cell carcinoma confined to the renal capsule, beyond the renal capsule, and lymph node involvement?
90-100%
50-60%
0-15% :(
What is a nephroblastoma?
Wilms Tumor seen in pediatric patients
Kids like having a blast
What is the MC renal cancer in peds?
Nephroblastoma
2/3 before 5
95% before 10
What causes nephroblastoma?
Sporadic loss of renal development and loss of tumor suppressor and transcription gene functions, leading to a single unilateral lesion most commonly
What are the s/s of nephroblastoma?
Abdominal pain (MC)
HTN
Hematuria
fever, anemia, N/V
often think it is a stomach bug
What is the initial imaging of nephroblastoma?
Abdominal US
then you can
Renal CT or MRI
What labs do you order for nephroblastoma?
CBC, CMP, UA, coag studies
sometimes see anemia and decreased GFR and increased BUN and Cr