Clear cell renal cell carcinoma (ccRCC) is the most common form of human kidney cancer. Histological and molecular analyses suggest that ccRCCs have significantly altered metabolism. Recent human studies of lung cancer and intracranial malignancies demonstrated an unexpected preservation of carbohydrate oxidation in the tricarboxylic acid (TCA) cycle. To test the capacity of ccRCC to oxidize substrates in the TCA cycle, we infused 13C-labeled fuels in ccRCC patients and compared labeling patterns in tumors and adjacent kidney. After infusion with [U-13C]glucose, ccRCCs displayed enhanced glycolytic intermediate labeling, suppressed pyruvate dehydrogenase flow, and reduced TCA cycle labeling, consistent with the Warburg effect. Comparing 13C labeling among ccRCC, brain, and lung tumors revealed striking differences. Primary ccRCC tumors demonstrated the highest enrichment in glycolytic intermediates and lowest enrichment in TCA cycle intermediates. Among human tumors analyzed by intraoperative 13C infusions, ccRCC is the first to demonstrate a convincing shift toward glycolytic metabolism. Courtney et al. conducted isotope tracing in clear cell renal cell carcinoma (ccRCC) patients and compared labeling patterns in primary ccRCC tumors and brain and lung tumors. They show enhanced glycolysis and reduced TCA cycle labeling in ccRCC tumors in vivo, which is consistent with the Warburg effect.

Original languageEnglish (US)
Pages (from-to)793-800.e2
JournalCell Metabolism
Issue number5
StatePublished - Nov 6 2018


  • cancer metabolism
  • clear cell renal cell carcinoma
  • human cancer
  • kidney cancer
  • mass spectrometry
  • nuclear magnetic resonance spectroscopy (NMR)
  • stable isotope tracing

ASJC Scopus subject areas

  • Physiology
  • Molecular Biology
  • Cell Biology


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