Which of the following is NOT a recognised risk factor for the development of renal carcinoma?
A. HypertensionAnswer B
Hypertension and the use of anti-hypertensive medications are associated with an increased risk of RCC. Studies have shown a clear dose-response relationship between elevated blood pressure and an increased risk of RCC. The independent contributions of hypertension and the use of antihypertensive medications have been difficult to separate, as most studies are based on a diagnosis of hypertension which is inevitably associated with treatment with antihypertensive drugs. Better control of blood pressure may lower RCC risk.
Whilst diabetes mellitus (DM) type 2 has been shown to be associated with an increased risk of several cancers, no significant increased risk has been demonstrated between DM and RCC [1]. Obesity has been established as a risk factor for RCC in a number of studies. A meta-analysis [2], demonstrated that the risk of RCC increased with elevated body mass index (BMI), with summary risk estimates (per 5 kg/m2 increase in BMI) of 1.24 in men and 1.34 in women. It has been proposed that the increased risk of RCC in obese patients may be due to increased exposure to oestrogens and androgens.
Cigarette smoking is a well-established risk factor for RCC. A meta-analysis of 24 studies showed that a history of smoking increases the risk of RCC compared to never smoking. Though the association between smoking and RCC is relatively weak, a dose-response relationship has been shown. Acquired renal cystic disease (ARCD) arises predominantly in patients with end-stage renal disease treated with haemodialysis. The incidence of RCC in ARCD is up to six times higher than in the general population. The risk of developing RCC does not appear to decrease after renal transplantation.