Recovery of Minimal Change Nephrotic Syndrome and Acute Renal Failure in a Patient withRenal Cell Carcinoma

Abstract

We describe a 78-year-old patient with nephrotic syndrome due to minimal-change glomerulopathy, associated with a renal adenocarcinoma. Oliguric acute renal failure requiring hemodialysis was also observed. Surgical removal of the tumor and corticosteroid therapy resulted in resolution of the nephrotic state and improvement of the renal function. Nephrotic syndrome is an unusual complication of renal cell carcinomas, and the association of minimal-change glomerulopathy (MCG) and solid tumors is particularly uncommon. In spite of this, MCG should be considered in the nephropathies causing nephrotic syndrome and acute renal failure in patients with renal malignancies.

Increased Risk of End-Stage Renal Disease in Patients with Renal Cell Carcinoma

“… 9 , 21 Other studies reported that minimal change nephropathy, immunoglobulin A glomerulonephritis, membranoproliferative glomerulonephritis, and rapidly progressive glomerulonephritis were rarely associated with RCC. 1 – 3 , 5 , 9 , 15 , 18 , 21 , 26 , 30 In the present study, we found that RCC is associated with an increased risk for ESRD. This might be explained by the presence of the above factors in our patients with RCC.…”

Acute Kidney Injury Associated with Renal Cell Carcinoma Complicated by Renal Vein and Inferior Vena Cava Involvement

“…However, the hemodynamic improvement in the left renal vein and concurrent recovery in the renal function after the initiation of axitinib [a potent selective inhibitor of vascular endothelial growth factor receptor 1, 2, and 3 which recently received marketing approval as an effective therapeutic for advanced RCC (14,15)] led us to conclude that the neoplastic thrombus should have disrupted the blood flow in the left renal vein, thereby leading to a rapid and progressive decline in the renal function before the sufficient development of collaterals. Such a scenario has rarely been mentioned in the previous literature describing cases of RCC with renal vein and IVC involvement as well as AKI (8,10,11,(16)(17)(18)(19)(20); thus, the significance of our experience should be evaluated carefully. We believe that in our case the benefit of radiological imaging using a contrast media outweighed the risk of nephrotoxicity, as is the case in some emergency circumstances (21).…”

Minimal Change Disease and Toxic Hepatitis Due to Ecstasy

“…It is thought that ecstasy may cause atypical clinical syndrome which is not seen frequently in MCD, such as the need for hemodialysis during the follow-up and the development of hepatotoxicity.Hepatic enzyme elevation was assessed as toxic hepatitis due to spontaneous regression of hepatic enzymes without drug exposure, hepatitis markers and imaging modalities being normal.Minimal change disease is the most common primary, ie idiopathic, cause of secondary causes include drugs, tumors, allergies, infections, other glomerular diseases (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). No laboratory or clinical findings were found in the patient's history suggesting any drug-taking history, allergy history and / or infection.…”