Is kidney cancer the same as uremia?

Written by Zhou Qi
Nephrology
Updated on February 17, 2025
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Kidney cancer and uremia are two completely different concepts. Kidney cancer refers to the presence of a malignant tumor, which is a malignant lesion in kidney-type tissues. Certain cells in the kidney are in a state of limitless proliferation, continuously replicating to form kidney-like masses, and may cause hematuria, or even squeeze kidney tissues affecting their function. Uremia, on the other hand, refers to long-term chronic damage to the kidneys from various diseases, leading to the destruction of over 90% of kidney tissue, rendering the kidneys unable to excrete metabolic waste. This results in azotemia, electrolyte disorders, and other complications, a state known as uremia. Patients with kidney cancer, if the damage to kidney tissues is not severe, may still have normal kidney function. However, if severe problems occur in both kidneys, kidney cancer could also lead to uremia, although this situation is relatively rare.

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kidney cancer immunotherapy drugs

The immunotherapy for kidney cancer often involves the use of interferons or interleukins, and the results are generally satisfactory. The effects of radiotherapy and chemotherapy for kidney cancer are not very certain. Typically, after kidney cancer is diagnosed, radical nephrectomy is performed. During the surgery, adequate exposure is essential. The renal hilum should be ligated first to prevent cancer cells from being squeezed into the bloodstream during surgery. It is also necessary to remove the fascia and fat around the kidney, along with the lymph nodes at the renal hilum. Combining these surgical measures with immunotherapy usually yields very ideal results.

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Difference between Renal Cancer and Renal Pelvis Cancer

First, the sites of the disease are different; renal pelvis cancer usually occurs in the epithelium of the renal pelvis or calyces, while renal cancer typically originates from the epithelial cells of the renal tubules. Second, the presentations are different; hematuria is a common symptom of both renal pelvis cancer and renal cancer. However, in renal pelvis cancer, hematuria can occur early, while in renal cancer, hematuria may not be seen until the tumor has invaded the renal pelvis or calyces. Third, the diagnostic tests are different; the clinical diagnosis of renal cancer heavily relies on CT scans, whereas renal pelvis cancer primarily depends on excretory or retrograde urography, that is, CT urography. Fourth, the CT appearances are different; on CT scans, renal cancer typically shows as a multicystic lesion with more pronounced enhancement during contrast than that seen in renal pelvis cancer. Fifth, the results of cytological examinations are different; cytology of renal pelvis cancer may show positive tumor cells, but renal cancer might test negative.

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Kidney cancer thrombus

Tumor thrombus is one of the common complications of tumors, and refers to cancer cells in blood vessels or lymphatic vessels similar to blood clots, i.e., cancer cells clustering together, invading the vessels, and causing abnormalities in blood coagulation function, leading to disorders in blood circulation and abnormal coagulation with clustered cancer cells. Generally, the risk of tumor thrombus formation is very high, and patients with tumor thrombus have much worse treatment outcomes than those without. Renal cancer is also a tumor commonly associated with tumor thrombus. Once a tumor thrombus occurs, it indicates that the surgery might be staged quite late, and thus, its treatment results are also relatively poor.

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What are the early symptoms of kidney cancer?

Kidney cancer is a common malignant tumor in the urinary system. Many patients with early-stage kidney cancer do not show any symptoms clinically and are incidentally discovered during medical examinations. Many patients in the early stages may also present with painless hematuria, sometimes as gross hematuria and sometimes as microscopic hematuria. Some patients may experience pain in the kidney area due to blood clots formed after hematuria, mainly presenting as intermittent episodes of mild back pain. Additionally, some patients in the early stages might show symptoms of paraneoplastic syndrome, such as hypertension and fever, but these clinical symptoms generally occur at a very low frequency. When patients present with obvious clinical symptoms, it often indicates that the kidney cancer has metastasized, leading to a clinical presentation of mid-to-late stage kidney cancer.

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Kidney cancer most commonly metastasizes to which locations?

Kidney cancer clinically tends to metastasize through direct spread, the lymphatic pathway, and the hematogenous pathway. The lymphatic route often involves enlargement of the perirenal lymph nodes or the lymph nodes in the groin or retroperitoneum. Kidney cancer is also prone to metastasize to the lungs, liver, bones, and other parts via the bloodstream. Similarly, kidney cancer can spread to the perirenal area, ureters, bladder, and other parts through direct extension. Once kidney cancer metastasizes to other organs, it is considered to be in the advanced stages clinically, and treatment primarily involves targeted therapy, chemotherapy, and other comprehensive treatment measures, with surgical treatment not being used as the primary anti-tumor treatment. Once kidney cancer has metastasized, the clinical staging is late, and the prognosis for the patients is poor.