Renal cell carcinoma and arterial hypertension.
BACKGROUND
The association between renal cell carcinoma and arterial hypertension has been the subject of various studies. These studies have not been consistent in clarifying the relationship between the two. Some authors contend that arterial hypertension is a consequence of renal cell carcinoma, which secretes vasoactive peptides. Others claim that arterial hypertension is a risk factor for the development of renal cell carcinoma. The purpose of our study is to assess if there is a direct connection between arterial hypertension and renal cell carcinoma.


METHODS
Out of 16,755 patients who were examined by ultrasonography, 40 were diagnosed with renal tumors. Of the 40 patients, 29 had malignant renal tumors, and 11 had benign renal tumors. These diagnoses were confirmed by CT scan, renal biopsy, and histology. Most of the patients with renal cell carcinoma (79.3%) had arterial hypertension. The group with benign renal tumors served as a control group. Out of the 29 patients with malignant renal cell carcinoma, 24 patients were treated with total nephrectomy, one had a partial nephrectomy, and four patients were too unwell for surgical intervention. In the group of those with benign renal tumors, seven patients had partial nephrectomies for the removal of angiomyolipomas. The personal histories were taken at the initiation of the study, and vital signs were obtained before and after surgery. Statistical analyses were performed using the Statistical Package for Social Sciences, version 10.0.


RESULTS
In the malignant group, the systolic blood pressure (SBP) before surgery was 157.41 +/- 27.86 mmHg, and the diastolic blood pressure (DBP) was 97.24 +/- 15.33 mmHg, while in the benign group, SBP was 134.55 +/- 17.53 mmHg, and DBP was 88.18 +/- 14.01 mmHg. In the malignant group in those who had undergone nephrectomies, the mean systolic pressure was 136.82, and the diastolic pressure was 85.90. In the benign group, the systolic and diastolic blood pressures were normal before and after surgery.


CONCLUSIONS
In the group of patients with both renal cell carcinoma and arterial hypertension, their hypertension was resolved after they underwent nephrectomies. In conclusion, our data suggest that renal cell carcinomas may cause arterial hypertension.
Stojanovic
Milan
M
Regional Medical Center and Hospital, Berane, Montenegro.
Goldner
Branislav
B
Diagnostic Imaging Center KBC "Bezanijska Kosa" Belgrade, School of Medicine, University of Belgrade, 11192 Beograd, Gocka 4, Belgrade, Serbia. goldy@ptt.rs.
Ivkovic
Dusan
D
School of Medicine, University of Belgrade, Belgrade, Serbia.
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome