Summary
The pathogenetic relationship between tumour and hypertension was investigated in 129 patients with renal cell carcinoma, of whom 41 (31.8%) were hypertensive. Of these 41 patients with renal tumours and hypertension, 6 (14.6%) were found to have primary reninism. In these patients the plasma renin activity in blood from the renal veins showed a tumour kidney to contralateral kidney ratio of between 4 and 7, and 2 patients also had secondary hyperaldosteronism. In the same 6 cases the renin content in the renal tumour tissue was significantly higher than that in tissue from the adjacent tumour-free renal cortex of the ipsilateral kidney. Immunohistochemical demonstration of renin in the tumour was only possible in these 6 cases. In 5 of these patients blood pressure returned to normal following nephrectomy; in the 6th case there was a drop in blood pressure after nephrectomy. In 3 renin-positive tumours examined, autonomous renin production was demonstrated in cell culture. Renin-producing renal cell carcinomas are an uncommon cause of renal hypertension. The differential diagnosis of hypertension should therefore also include renal tumour.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Berglund G, Andersson O, Wilhelmsen L (1976) Prevalence or primary and secondary hypertension: studies in a random population sample. Br Med J 2:554–559
Cantin M, Gutkowska J, Lacasse J, Ballak S, Ledoux S, Inagami T, Bcuzeron J, Genest J (1984) Ultrastructural immunocytochemical localization of renin and angiotensin II in the juxtaglo-merular cells of the ischemic kidney in experimental renal hypertension. Am J Pathol 115:212–224
Conn JW, Cohen EL, Lucas CP, McDonald WJ, Mayor GH, Blough WM, Eveland WC, Bookstein JJ, Lapides J (1972) Primary reninism. Hypertension, hyperreninemia and secondar hyperaldosteronism due to renin-producing juxtaglomerular cell tumors, Arch Intern Med 130:682–696
Ganguly A, Gribble J, Tune B, Kemson RL, Luetscher JA (1973) Renin-secreting Wilms tumour with severe hypertension. Ann Intern Med 79:835–837
Greminger P, Vetter W, Zimmermann K, Beckerhoff R, Siegenthaler W (1977) Primäre und sekundäre Hypertonie in einem poliklinischen Patientengut. Schweiz Med Wochenschr 107:605
Hackenthal E, Poulsen K, Taugner Ch, Taugner R (1980) Localization of renin in mouse kidney by the peroxidase-antiperoxidase technique. In: Gross F, Vogel G (eds) Enzymatic release of vasoactive peptides. Raven, New York, pp 62–72
Hillifield JW, Page DL, Smith C, Michelakis AM, Staab E, Rhamy R (1977) Renin-secreting clear cell carcinoma of the kidney. Arch Intern Med 135:859–864
Kameya T, Shimosata Y, Abe K, Takenchi T (1980) Morphologic and functional aspects of hormone-producing tumours. In: Sommers SC, Rosen PP (eds) Pathology annual. Appleton-Century Crofts, New York, pp 351–386
Kifor J, Dzau VJ (1987) Endothelial renin-angiotensin pathway: evidence for intracellular synthesis and secretion of angiotensins. Circ Res 60:422–428
Kumar S, Winearls CG, Owen DL (1982) Facial palsy with severe hypertension due to renal tumor. Br Med J 285:1266–1269
Lebel M, Talbot J, Grose J, Morin J (1977) Adenocarcinoma of the kidney and hypertension: report of two cases with special emphasis on renin. J Urol 118:923–927
Leckie B, Brown JJ, Fraser R, Kyle K, Lever AF, Morton JJ, Robertson JIS (1978) A renal carcinoma secreting inactive renin. Clin Sci Mol Med 55:159–161
Lilly LS, Pratt RE, Alexander RW, Larson DM, Ellison KE, Gimbrone MA Jr, Dzau VJ (1985) Renin expression by vascular endothelial cells in culture. Circ Res 57:312–318
Linder F (1947) Über blutdrucksteigernde Nierentumoren. Klin Wochenschr 24/25:498–502
Lindop GBM, Fleming S (1984) Renin in renal cell carcinomaan immunocytochemical study using an antibody to pure human renin. J Clin Pathol 37:27–31
Lindop GBM, More IAR, Leckie B (1983) An ultrastructural and immunocytochemical study of a renal carcinoma secreting inactive renin. J Clin Pathol 36:639–645
Lindop GBM, Fleming S, Gibson AAM (1984) Immunocytochemical localization of renin in nephroblastoma. J Clin Pathol 37:738–742
Mast GJ, Isenberg E, Ziegler M, (1981) Renale Hypertonie als Folge urologischer Erkrankungen. Urologe [A] 20:123–129
Menard J, Soubrier F, Bariety J, Camilleri JP, Corvol P (1983) Hypertension. Primary reninism. In: Genest J (ed) Hypertension. McGraw Hill, New York, pp 1034–1040
Moss AH, Peterson LJ, Scott CW, Winter K, Olin DB, Garber RL (1982) Delayed diagnosis of juxtaglomerular cell tumour with hypertension. N C Med J 43:705–707
Novick AC, Pohl MA, Schreiber M, Grifford RW Jr, Vidt DG (1983) Revascularization for preservation of renal function in patients with atherosclerotic renovascular disease. J Urol 129:907–912
Robertson PW, Klidjian A, Harding LK, Walters G, Lee MR, Robb-Smith AHT (1967) Hypertension due to a renin-secreting renal tumour. Am J Med 43:963–976
Rocella EJ and Working Group on Renovascular Hypertension (1987) Detection, evaluation and treatment of renovascular hypertension. Arch Intern Med 147:820–829
Sheth KJ, Tang JJ, Blaedel ME, Good TA (1978) Polydipsia, polyuria and hypertension associated with renin-secreting Wilm's tumour. J Pediatr 92:921–924
Spahr J, Demers LM, Shochat SJ (1981) Renin producing Wilm's tumour. J Pediatr Surg 16:32–34
Steffens J, Bock R, Braedel HU, Isenberg E, Bührle CP, Ziegler M (1990) Renin producing renal cell carcinoma. Eur Urol 18:56
Steffens J, et al. (1991) Segmental renal hypoplasia of vascular origin causing renal hypertension in a 3-year-old girl. J Urol 146:826
Sternberger LA, Hardy PH Jr, Cuculis JJ, Meyer HG (1970) The unlabeled antibody enzyme method of immunohistochemistry. Preparation and properties of soluble antigen-antibody-complex (horseradish peroxidase-anti-horseradish-peroxidase) and its use in the identification of spirochetes. J Histochem Cytochem 18:315–333
Taugner C, Poulsen K, Hackenthal E, Taugner R (1979) Immunohistochemical localization of renin in mouse kidney. Histochemistry 62:19–27
Taugner R, Bührle CP, Ganten D Hackenthal E, Hardegg C, Hardegg G, Nobiling R (1983) Immunohistochemistry of the tenin-angiotensin-system in the kidney. Clin Exp Hypertens [A] 5:1163–1177
Tetu B, Totovic V, Bechtelsheimer H, Smend J (1984) Tumeur rénale à sécrétion de rénine. Ann Pathol 4:55–59
Tomita T, Poisner A, Inagami T (1987) Immunohistochemical localization of renin in tumors. Am J Pathol 126:73–80
Wise KL, McCann RL, Dunnick NR, Paulson DF (1988) Renovascular hypertension. J Urol 140:911–924
Yokomori K, Hori T, Takemura T, Tsuchida Y (1988) Demonstration of both primary and secondary reninism in renal tumors in children. J Pediatr Surg 23:403–409
Ziegler M, Mast GJ (1986) Experimentelle Grundlagen und Klinik der renalen Hypertonie unter urologischen Aspekten. In: Rosenthal J (ed) Hypertension, Springer, Berlin Heidelberg New York p 331
Ziegler M, Althoff J, Mitsche L, Möhring H, Möhring K, Krempien B (1971) Renin in renal carcinoma tissue (abstract). European Society for Clinical Investigation Fifth Annual Meeting, Scheveningen, p 96
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Steffens, J., Bock, R., Braedel, H.U. et al. Renin-producing renal cell carcinomas—clinical and experimental investigations on a special form of renal hypertension. Urol. Res. 20, 111–115 (1992). https://doi.org/10.1007/BF00296521
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00296521