Can Kidney Disease Cause Kidney Cancer? What Patients Should Know
More Programs and Publications Featuring Dr. Kyle Riding
In this program:
Is there a link between kidney disease and kidney cancer? Medical laboratory scientist Dr. Kyle Riding discusses the possible link between the two conditions, diagnostic tests that screen for kidney issues, and how to be proactive if diagnostic tests are showing conflicting results.
Transcript
Deandre White:
This is a hot topic for many patients in our community. Statistics show that African Americans, Hispanics, and American Indians are at a higher risk for developing kidney failure. Do you feel that there is a link particularly between kidney disease and kidney cancer?
Dr. Kyle Riding:
So, yes. There is some evidence in the published literature that there is a link between chronic kidney disease and kidney cancer. We actually find that this is a bi-directional relationship in terms of risk, meaning that chronic kidney disease is a risk factor for kidney cancer and vice versa. Kidney cancer is a risk factor for chronic kidney disease. Now, the full mechanism behind that risk is not fully clarified yet at this time. However, we do believe that certain lifestyle factors that are a risk for both of them are going to be the reason behind that linkage. In addition, we think that certain toxins that are going to be really causing the kidney cancer could also be leading to the chronic kidney disease first. So there is definitely a relationship there, and research is still ongoing to really clarify that relationship much more clearly.
Deandre White:
And what can patients look for from the very beginning before even going to a kidney specialist to say, maybe I'm at risk of having kidney disease or kidney cancer, or vice versa?
Dr. Kyle Riding:
So one of the more powerful screening tools that we have when it comes to kidney function, there are two of them. The first is just the routine urinalysis. Every time that you go for your annual physical, which I hope you're keeping up with, you are asked to pee in the cup and a routine urinalysis is typically performed. That routine urinalysis gives us a lot of information about what is going on with your kidneys, from whether there's inflammation happening in your kidneys to is there an infection going on, or could there be signs of diabetes because there's sugar in your urine now. So that urinalysis is a really powerful tool.
Now, the blood test that is also a very powerful tool that can help you monitor your kidney function is what we call the eGFR or the estimated glomerular filtration rate, which is a really fancy way for saying we calculate how quickly your kidneys are filtering your blood. And if your kidney function is compromised, what will happen is that rate will decrease. The kidneys aren't working as well. And so if that eGFR result is going down over time, which is part of the normal aging process, but if you're seeing it precipitously go down over time, You should probably talk to first, your general practitioner, and then consider consulting a nephrologist or a kidney specialist at that point.
Deandre White:
Is it true that there is a distinction from African American and non-African Americans in terms of how this is even measured?
Dr. Kyle Riding:
Yes. And that's an unfortunate issue that medicine is trying to work through right now. Back when the eGFR was first formulated, the study populations that they drew upon, drew some incorrect conclusions about African American patients. They concluded that the patients in their study who were Black actually had more muscle mass and so needed a correction factor built into this calculated result that we give. Here's the problem. That muscle mass difference between races actually has no basis in biology, is what we've uncovered over time. Now the problem with that is, the correction factor causes the eGFR results for Black patients to be higher than the eGFR for white patients. Which means it takes longer for Black patients to have kidney disease recognized. And so medicine has now realized, "Oh, this race correction factor in the eGFR, really not a great idea." And so many facilities are starting to take it off of their testing menu and hopefully it will just be abolished altogether in the next couple of years.
Deandre White:
Yes. And I think I want to add to that is I've seen in my labs, I've seen labs before that include both numbers for patients. And as a patient, I think it's important for you to go through all of your labs with your doctor and make sure that if both are listed, that they're going off of the right one and not the one that looks like you basically.
Dr. Kyle Riding:
And so an actionable item I would really ask patients to consider, if you are a patient who has an eGFR result and you just happen to have a concern about your kidney function, whether that's because you have diabetes or because you have high blood pressure, you have cancer, or you're just concerned about your kidney function, because you're a living, breathing human that worries about your health, and you're given these two results...because usually the patient will get both: the non-corrected and the corrected eGFR. You get those two like you mentioned. If there's a discrepancy between them where one of them is saying, "Hey, your kidney function is low, not working as well," and the other one is saying, "Yeah, your kidneys are fine," bring both of those to your physician and say, "If this was you, what would you want to do with that result?" My bet is, if you frame it that way to your physician, they're probably going to have you looked at by a nephrologist because that one result is suggestive that kidney function is compromised and it's better safe than sorry when it comes to such important organs.
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