Chronic Kidney Disease (CKD) patients face an elevated risk of developing kidney cancer, a silent condition often presenting with symptoms easily mistaken for CKD itself, such as blood in the urine, persistent flank pain, profound fatigue, unexplained weight loss, recurrent fevers or night sweats, and unusually high haemoglobin levels. Globally, kidney cancer rates have more than doubled in recent decades due to factors including an aging population, obesity, hypertension, smoking, and CKD, yet early detection significantly enhances curability, underscoring the critical importance of awareness and timely medical evaluation for any new or unusual health changes, especially for individuals with advanced CKD, acquired cystic kidney disease, or long-term dialysis dependency who require regular monitoring.

Chronic Kidney Disease (CKD) patients face an elevated risk of developing kidney cancer, a silent condition often presenting with symptoms easily mistaken for CKD itself, such as blood in the urine, persistent flank pain, profound fatigue, unexplained weight loss, recurrent fevers or night sweats, and unusually high haemoglobin levels. Globally, kidney cancer rates have more than doubled in recent decades due to factors including an aging population, obesity, hypertension, smoking, and CKD, yet early detection significantly enhances curability, underscoring the critical importance of awareness and timely medical evaluation for any new or unusual health changes, especially for individuals with advanced CKD, acquired cystic kidney disease, or long-term dialysis dependency who require regular monitoring.

Chronic Kidney Disease (CKD) patients face an elevated risk of developing kidney cancer, a silent condition often presenting with symptoms easily mistaken for CKD itself, such as blood in the urine, persistent flank pain, profound fatigue, unexplained weight loss, recurrent fevers or night sweats, and unusually high haemoglobin levels. Globally, kidney cancer rates have more than doubled in recent decades due to factors including an aging population, obesity, hypertension, smoking, and CKD, yet early detection significantly enhances curability, underscoring the critical importance of awareness and timely medical evaluation for any new or unusual health changes, especially for individuals with advanced CKD, acquired cystic kidney disease, or long-term dialysis dependency who require regular monitoring.

Most individuals, when they hear the phrase ‘Chronic Kidney Disease’ (CKD), think about deteriorating kidney function, rising creatinine levels, dialysis or maybe the prospect of a kidney donation. 

What many people don't understand is that CKD can also raise the chance of developing kidney cancer, particularly in those with advanced renal disease or people who have been on dialysis for many years.

On the occasion of World Kidney Cancer Day, it is important to highlight a disease that often progresses silently and without warning. Kidney cancer can hide for years, unlike many diseases that announce themselves early. By the time symptoms develop, the disease may have advanced.

Kidney cancer can be particularly tricky to spot for those with CKD. Its warning indications are similar to the frequent symptoms of chronic renal disease and can be easily dismissed as part of the underlying ailment.

Recent global stats provide a disturbing story. The frequency of kidney cancer cases globally has more than doubled in the previous three decades due to variables such as ageing populations, obesity, hypertension, smoking and chronic renal disease. These figures are troubling, but there is also a tremendous message of hope: kidney cancer is generally extremely curable when caught early.

Awareness is still one of our best weapons.

Here are five signs you need to pay attention to:

1. Urine with Blood

Blood in the urine is one of the most crucial warning symptoms of kidney cancer. Sometimes the shift is evident, with urine appearing pink, crimson or dark brown. In other circumstances, blood can only be found on normal urine tests.

Urinary anomalies are quite common in patients with CKD; therefore, single episodes could be overlooked. But even one inexplicable event is worth seeing a doctor about. Further evaluation may be required if common reasons, such as infection or kidney stones, have been ruled out.

2. Ongoing pain in the side or lower back

Back discomfort doesn’t always result from bad posture or a pulled muscle.

Kidney cancer can also cause a dull, constant discomfort in the side/back area of the body, between the ribs and the hips. It is usually one-sided, and unlike normal muscular pain, the soreness might last for weeks.

This symptom is easy to miss because many people with chronic renal disease already have aches and pains. But any lasting flank pain that doesn’t get better should be discussed with a health care specialist.

3. A different kind of fatigue

Fatigue is almost synonymous with chronic kidney disease. Fatigue can be caused by anaemia, metabolic abnormalities and decreased kidney function.

But cancer-related weariness is a little different. Patients often complain of an overpowering weariness that does not improve with sleep, rest or therapy for anaemia. It can interfere with daily life and leave people feeling tired for no reason.

If renal disease has been stable elsewhere, a noticeable drop in energy levels should not be dismissed.

4. Loss of weight for no reason

Some people might like the idea of losing weight without ever lifting a finger, but this might be a huge red flag.

If you’re losing weight and your clothing is fitting looser or the numbers on the scale keep going down with no modifications to your diet or exercise routine, it’s worth looking into.

Cancer can change the body’s metabolism and cause inflammatory responses that can contribute to weight loss. Unexplained weight loss in patients with CKD should not be automatically ascribed to renal disease alone.

5. Recurrent night sweats or fevers

When fever occurs, infection is often the first thing that springs to mind. Sometimes, though, cancer might cause identical symptoms.

Inflammatory alterations from a tumour might result in recurrent low-grade fevers, night sweats and a prolonged feeling of being sick.

This sensation can be especially puzzling to CKD patients because they are more susceptible to infections. If symptoms persist despite therapy or repeated testing that do not detect an illness, there may be a need for additional research.

6. Unexpected increase in haemoglobin levels

Patients with chronic kidney disease often suffer from anaemia because damaged kidneys produce less erythropoietin, the hormone that stimulates red blood cell synthesis. Therefore, low haemoglobin is prevalent in CKD. However, a rapid or unexpected rise in haemoglobin levels, especially in patients not on larger doses of erythropoietin-stimulating agents, may require more attention. Some kidney tumours, notably renal cell carcinoma, can create too much erythropoietin. 

This is not a typical presentation, but an unexplained rise in haemoglobin levels in a patient with established CKD should not necessarily be accepted as good news. In clinical situations, it may be a pointer that warrants further assessment to exclude an underlying renal tumour.

Why early detection is important

The good news is that kidney cancer that’s found early often can be treated successfully. Better imaging has meant many tiny tumours are now found before they cause symptoms, which has improved treatment and survival.

Those with advanced CKD, acquired cystic kidney disease, or long-term dialysis dependency especially need regular monitoring. Routine check-ups, ultrasound tests, and timely imaging studies can detect changes before they become significant.

A major concern for individuals with chronic renal disease is that they assume any new symptom is just part of the current condition.

Any change in your regular state of health is worth noting. Don't ignore blood in the urine, unexplained weight loss, chronic pain, unusual weariness, recurring fevers or night sweats.

The message for World Kidney Cancer Day is simple: listen to your body, be informed and seek medical help if something feels odd. Early detection saves lives, and awareness is the first step.

The author is a consultant nephrologist and transplant physician at HOSMAT Hospitals.

 

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK. 

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