Lin X, et al. - Researchers recognized 311 nephrectomies of non-functioning kidneys and characterized them into acquired cystic kidney disease (ACKD, n = 61), end-stage renal disease, nonspecific (ESRD, n = 63), adult polycystic kidney disease (APKD, n = 49), failed transplant kidneys (FTK, n = 96) and those caused by obstructive conditions in the kidney (OCK, n = 42) in order to determine the pathologic characterization of renal epithelial neoplasms arising in non-functioning kidneys. In contrast to ESRD, APKD, and FTK, ACKD individuals had notably prolonged dialysis duration. Although they had a comparable risk for clear cell renal cell carcinoma and papillary RCC, ACKD individuals had a much greater risk for ACKD-correlated RCC and clear cell papillary RCC in comparison with ESRD individuals. Thus, for prognosticating kidney cancer risk, precise clinicopathologic classification of these non-functioning kidneys is significant. Moreover, these outcomes show the necessity for active monitoring of individuals with high-risk non-functioning kidney diseases and suitable surgical treatment when needed.