This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Kidney, Subject name: Medicine
The commonest systemic abnormality associated with renal cell carcinoma Is - 
Select and explain. 
A. Hypeension, B. Polycythemia, C. Elevated ESR, D. Pyrexia
C: Elevated ESR
Answer: C: Elevated ESR 
Explanation: The preoperative erythrocyte sedimentation rate is an independent prognostic factor in renal cell carcinoma. An elevated erythrocyte sedimentation rate (ESR) repoedly has been associated with a poor prognosis among patients with RCC, but the ESR is not incorporated into existing nomograms Ref Harrison20th edition pg 288