Renal cell cancer : a molecular-epidemiological approach to unravel new pathways underlying disease etiology and prognosis

Kidney cancer is the seventh most common cancer, yet its cause remains unknown. This dissertation examines the risk factors and physiological mechanisms that could play a role in the development of kidney cancer within the framework of a Dutch cohort study (NLCS). High salt intake was identified as a new potential risk factor for kidney cancer, particularly among participants with low fluid intake. The link between salt intake and kidney cancer could not be explained by the participants’ high blood pressure, but could be partially explained by genetic variation in the renin-angiotensin-aldosterone system (RAAS), which regulates blood pressure, salt intake and fluid levels in the kidneys. By classifying kidney tumours according to tumour heterogeneity based on epidemiological changes, we demonstrated that potassium intake increased the risk of kidney cancer in one group of tumours and reduced the risk in others. Risk factors can therefore differ as a result of tumour heterogeneity, which should be taken into account in future research.
This research was financed by the Dutch Cancer Society.