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We further examined whether BHDflox/flox/ Ksp-cre mice develop renal carcinomas along with the cysts.

Interestingly, Tsc2 mice develop renal cystadenomas [ 28].

This has been confirmed using proof of principle experiments in the mouse, where both copies of Apc have been removed from the kidney and only a small fraction of mice develop renal carcinoma.

Slc9a3r1 (NHERF-1) deficient mice develop renal phosphate wasting, but the majority of female mice also had a 25 30% reduction in bone mineral density and a 40% decrease in bone mineral content with multiple fractures [ 34].

Tsc2+/− mice develop renal cysts and carcinomas that display Tsc2 loss of heterozygosity (LOH) and increased mTORC1 activity (Kobayashi et al, 1999; Onda et al, 1999), while Akt activity is suppressed (Harrington et al, 2005; Manning et al, 2005).

Indeed, using the AhCre transgene, which yields constitutive Cre expression within a high proportion of cells of the kidney, less than 1/3 of mice develop renal carcinoma, despite showing the presence of small premalignant lesions at much earlier ages (Sansom et al, 2005).

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Flcn heterozygous knockout mice developed renal neoplasia and cysts as they aged, with concomitant loss of the wildtype copy of Flcn [26].

Akita mice developed renal structural damage compared with WT and Hnrnpf-Tg mice (ESM Fig.  1a, PAS staining), including tubular luminal dilatation with accumulation of cell debris, increased extracellular matrix proteins in glomeruli and tubules, and proximal tubule cell atrophy.

Although all kidneys from the AhCre Apc fl/fl mice showed a significant number of cells with nuclear β-catenin (Fig 1C) compared to none in wild-type mice (Supporting Information 2A) by 6 months, approximately 40% had developed premalignant lesions (Fig 1E), very few mice developed renal carcinoma (at 1 year of age only 8%, 2 out of 24 mice).

AIRmax and AIRmin mice are known to differ in susceptibility to chemically induced tumors [ 8– 10], and here we show that they also differ in susceptibility to spontaneous tumors: in the absence of any carcinogenic treatment, >50% of AIRmin mice developed renal tumors at 57 weeks of age, whereas no AIRmax mouse did.

AIRmax mice did not develop renal tumors spontaneously nor in response to urethane, whereas in AIRmin mice renal tumors formed spontaneously (in 52% of animals) and after urethane induction (89%).

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