The biggest risk factor for developing stage 4 kidney cancer is having had an earlier stage of kidney cancer that goes undiagnosed or untreated. There are quite a few other risk factors for developing kidney cancer in the first place. Physical issues like high blood pressure and obesity may increase your risk for developing kidney cancer. Smoking is another significant risk factor for stage 4 kidney cancer. Age and sex may also affect your risk - because kidney cancer more commonly affects males, and is most common among adults over age 40, being an adult male may increase your risk. Certain inherited conditions such as Von Hippel-Lindau disease can increase your risk for stage 4 kidney cancer. Also, if you've been on dialysis for many years to treat kidney failure, you may have an increased risk. Other environmental factors - like exposure to certain toxic substances such as asbestos, cadmium - may also increase your risk.