The Association of Cancer and the Nephrotic Syndrome

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Abstract
In a series of 101 patients who presented with idiopathic nephrotic syndrome (University of California Hospitals and Clinics) in a 10-year period (1953-1962), 11 were found to have cancer at a closely related time in the course of their illness. This incidence of cancer associated with idiopathic nephrotic syndrome is unusually high (10.9 %) when compared with other population groups. Known causes of the nephrotic syndrome such as amyloidosis, diabetic glomerulosclerosis, and renal vein thrombosis were eliminated from the study. Diagnosis of the renal lesion was confirmed by renal biopsy and/or autopsy in 89 of the 101 cases of nephrotic syndrome, including 10 of the 11 with cancer. Of these 11, the renal tissue diagnosis was lipoid nephrosis (1 case), membranous glomerulonephritis (9 cases), and lobular glomerulonephritis (1 case). It is known that a patient with neoplastic disease will frequently develop antibody against tumor antigen. Also, membranous lesions of the glomerulus can be produced by antigen-antibody complex. The high coincidental occurrence of cancer and of the membranous type of renal lesion suggests a possible relationship between the two. It may be that host antigen-antibody complex, induced by a neoplasm, is capable of attachment to glomerular basement membrane, producing a membranous type of glomerulonephritis and the nephrotic syndrome. In view of these observations, adult patients with idiopathic nephrosis should be carefully screened for cancer.

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