Neuroblastoma and the Kidneys: Understanding Risks and Symptoms

Explore how neuroblastoma interacts with kidney health, including symptoms, risks, and treatment considerations.

By Medha deb

Created on Sep 25, 2025

Explore how neuroblastoma interacts with kidney health, including symptoms, risks, and treatment considerations.

Neuroblastoma and the Kidneys: What You Need to Know

Neuroblastoma is a rare type of cancer that commonly affects infants and young children. While it usually originates near the kidneys—in the adrenal glands—it may spread to or impact kidney function in various ways. Understanding how neuroblastoma interacts with the kidneys is vital for early detection, effective treatment, and supportive care, especially for young patients facing this diagnosis.

What is Neuroblastoma?

Neuroblastoma is a cancer that begins in immature nerve cells, known as neuroblasts. These cells are part of the sympathetic nervous system, which controls functions like heart rate and digestion. Neuroblastoma is the most common cancer in infants and the second most common childhood cancer overall. A significant proportion of cases are diagnosed in children younger than five years, with roughly half of all diagnoses occurring in those under 17 months old.

Primary Site: Most commonly starts in the adrenal glands, which are located on top of each kidney.
Other Sites: Can also emerge anywhere in the body along sympathetic nerves, including the chest, neck, and pelvis.
Spread (Metastasis): Frequently spreads to lymph nodes, bone marrow, bones, liver, or other nearby tissues, including the kidneys.

How Does Neuroblastoma Affect the Kidneys?

Although neuroblastoma typically starts in the adrenal glands near the kidneys, it can impact kidney health in multiple ways:

Compression: Tumors may push against the kidneys or kidney arteries, potentially leading to symptoms such as high blood pressure.
Direct Spread: Neuroblastoma can invade the kidneys or nearby structures as it grows.
Paraneoplastic Effects: Neuroblastoma cells can secrete hormones affecting multiple organs, including the kidneys.
Rare Origin: Very rarely, neuroblastoma may originate from nerve cells inside the kidney itself.

Can Neuroblastoma Cause Kidney Symptoms?

Symptoms related to the kidneys can manifest if the neuroblastoma grows large enough to affect nearby tissues or blood vessels, or if hormonal disruption occurs. Kidney-affecting symptoms aren’t always present, but when they appear, they can include:

A non-tender lump or swelling in the abdomen or lower back.
Pain in the belly or flank.
Blood in urine (rare, usually if a tumor invades the kidney).
Difficulty urinating if the tumor compresses the urinary tract.
Swelling in legs or (for boys) the scrotum, due to pressure on blood vessels.

High blood pressure can occur if the tumor compresses the renal artery, affecting blood flow to the kidney.

Some forms of neuroblastoma lead to a phenomenon called paraneoplastic syndrome, in which the tumor produces hormones that affect organs throughout the body, including the kidneys. These can cause:

Watery diarrhea
Rapid heartbeat (tachycardia)
Fever and sweating
Flushing of skin
High blood pressure

General Signs and Symptoms of Neuroblastoma

Children with neuroblastoma may have a wide range of symptoms, depending on the tumor’s location and how far it has spread (metastasized). Many symptoms are not specific to the kidneys, but can help alert families and doctors to a potential problem:

Abdominal swelling or a palpable mass
Loss of appetite or unexplained weight loss
Fullness or pain in the belly
Bone pain (if the cancer has spread to the skeleton)
Bruising or bleeding easily (if the disease affects bone marrow)
Fatigue, pallor, or tiredness
Education of eye symptoms: Bulging eyes or dark circles around the eyes (sometimes called “raccoon eyes”)
Painless bluish lumps under the skin in infants
Weakness or paralysis (loss of movement) if the tumor is pressing on the spinal cord
Difficulty urinating or passing stool

Less frequent symptoms may be due to hormonal changes caused by the tumor, such as persistent diarrhea, rapid heartbeat, or episodes of flushing and sweating.

Anatomy: The Adrenal Glands, Kidneys, and Beyond

To understand the link between neuroblastoma and kidney health, it’s essential to be familiar with the anatomy involved:

The kidneys are bean-shaped organs located in the back of the abdomen. Their main function is to filter waste and balance fluids.
Sitting atop each kidney is an adrenal gland, which produces essential hormones involved in stress response, blood pressure regulation, and metabolism.
Neuroblastoma almost always begins in one of these adrenal glands, but can appear anywhere along the chain of sympathetic nerve tissue in the body.

How Neuroblastoma Spreads

Neuroblastoma has a strong tendency to metastasize (spread). Common sites for metastasis include:

Other nearby organs, such as the kidney, liver, and spinal cord
Lymph nodes
Bone marrow
Skeletal bones
Skin or soft tissue (especially bluish lumps)

With spread to the kidneys, direct invasion can lead to impaired kidney function, blood pressure regulation problems, and symptoms like blood in the urine or swelling.

Kidney Damage and Complications

Direct kidney involvement from neuroblastoma is rare, but possible. When tumors compress the renal arteries or invade kidney tissue, they may cause:

High blood pressure (hypertension) due to reduced blood flow
Kidney swelling (hydronephrosis) if the tumor blocks urinary drainage
Reduced kidney function if blood supply is compromised for extended periods

Most often, the main risk to the kidneys is compression or nearby spread rather than a tumor originating in the kidney itself.

Is Neuroblastoma a Type of Kidney Cancer?

Despite its close proximity to the kidneys and potential to invade kidney tissue, neuroblastoma is not classified as a type of kidney cancer. The most common kidney cancer in children is Wilms tumor, which arises directly from kidney cells. Neuroblastoma arises from nerve tissue (neuroblasts), typically in the adrenal glands above the kidneys or along the sympathetic nervous system.

Tumor Type	Usual Origin	Age Group Affected	Relation to Kidneys
Neuroblastoma	Nerve tissue (sympathetic nervous system, adrenal glands)	Infants, young children	May compress or invade kidneys, but rarely originates there
Wilms Tumor	Kidney tissue (nephroblastoma)	Young children	Originates in the kidney itself

Diagnosis and Early Detection

Neuroblastoma diagnosis often begins with a thorough physical exam, followed by imaging tests such as ultrasound, CT scan, or MRI to locate the tumor and assess possible spread. Urine and blood tests may also be done to check for substances produced by neuroblastoma cells. Biopsy is ultimately required to confirm the diagnosis.

Imaging: Detects the location and size of the tumor, spread to the kidneys, liver, spine, or lymph nodes.
Urine tests: Measure levels of catecholamine metabolites, which are often elevated in neuroblastoma.
Biopsy: Provides confirmation by examining tumor cells under a microscope.

Survival Rate and Prognosis

Outcomes for children with neuroblastoma depend on several factors, including:

Child’s age at diagnosis
Tumor stage and risk classification
Tumor genetic and biological features
Extent of spread (metastasis), including whether kidneys are involved

Neuroblastoma in infants and younger children tends to have a better prognosis than in older children. Tumors that have not spread and can be completely removed have a much higher survival rate than advanced or high-risk tumors. Modern therapies, including surgery, chemotherapy, radiation, and immunotherapy, have improved survival rates significantly in recent decades.

Treatment Options for Neuroblastoma

Treatment choices depend on risk level, which incorporates age, tumor stage, and specific genetic markers. Options may include:

Surgery: Removal of the primary tumor (and, if needed, kidney or surrounding tissue that is directly involved).
Chemotherapy: Used before or after surgery to shrink the tumor and kill any cancerous cells that have spread.
Radiation therapy: Reserved for cases where surgery and chemotherapy do not eliminate the cancer completely.
Stem cell transplantation: For high-risk neuroblastoma, replacing bone marrow after high-dose chemotherapy.
Immunotherapy: Boosts the immune system to attack cancer cells.
Targeted therapy: Drugs that interfere with specific characteristics of cancer cells.

Frequently Asked Questions (FAQs)

Does neuroblastoma always spread to the kidneys?

No, the majority of neuroblastomas start near the kidneys in the adrenal glands or along sympathetic nerves elsewhere in the body. While the tumor can spread to the kidney or nearby areas, this is not always the case.

What are the early signs of kidney involvement in neuroblastoma?

Symptoms may include abdominal swelling, reduced urine output, blood in the urine, and high blood pressure. Early-stage kidney involvement is often silent and detected only through imaging.

How is neuroblastoma in children different from kidney cancer?

Neuroblastoma arises from nerve tissues, most commonly in the adrenal glands, while kidney cancer (Wilms tumor) originates from kidney cells. Both are pediatric cancers, but they differ in origin, treatment, and prognosis.

Can neuroblastoma recur in the kidneys?

Neuroblastoma can recur in any site where it previously occurred or spread. Ongoing monitoring is essential for early detection of recurrence, whether in the kidneys, bone marrow, or other areas.

What long-term effects can neuroblastoma treatment have on the kidneys?

Depending on how treatment affects the kidneys (especially if surgery or radiation directly involves kidney tissue), some children may develop reduced kidney function or high blood pressure later in life. Regular follow-up is recommended for monitoring kidney health.

When to See a Doctor

Any new or persistent symptoms—unexplained swelling, lumps, unexplained bruising, or changes in urination—should be evaluated by a pediatrician. Early and accurate diagnosis is vital for the best outcome.

Takeaway

Neuroblastoma is a significant childhood cancer that frequently begins near the kidneys and can, in some cases, affect kidney health, either by direct spread, compression, or hormonal effects. Understanding the symptoms, risks, and available treatments empowers families to seek early medical attention and access appropriate care.

Neuroblastoma most often develops in the adrenal glands, close to the kidneys.
It can spread to or press against the kidneys, causing various symptoms.
Symptoms may be vague in early stages but often include swelling, pain, and hormonal changes.
Prompt recognition and comprehensive medical care are key to improving outcomes.

Speak to your healthcare provider if you notice any concerning symptoms in your child. Ongoing research continues to improve outcomes and quality of life for children diagnosed with neuroblastoma.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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