Metabolic reprogramming in clear cell renal cell carcinoma

Key Points The incidence of kidney cancer, particularly clear cell renal cell carcinoma, is increasing and knowledge of its pathophysiology is essential for nephrologists Reprogramming of metabolic pathways enables cancer cells to rapidly proliferate, survive in conditions of nutrient depletion and hypoxia, and evade the immune system Most forms of kidney cancer are associated with reprogramming of metabolic pathways including oxygen sensing, the tricarboxylic acid cycle and the metabolism of tryptophan, fatty acids, glucose, glutamine and arginine Metabolic reprogramming provides opportunities for functional imaging approaches based on the altered pathways Novel therapies for kidney cancers that target critical proteins or enzymes that are involved in dysregulated metabolic pathways are being developed