Mutations in fumarate hydratase are found among patients suffering from kidney cancers, and mutations in succinate dehydrogenase were found in patients with pheochromocytoma and paragangliomas. These mutations cause a disruption of the TCA cycle with the accumulation of fumarate or succinate, both of which can inhibit dioxygenases or prolyl hydrolases that mediate the degradation of HIF proteins. HIF-1 could be elevated under aerobic conditions downstream from activated PI3K, which stimulates the synthesis of HIF-1. Loss of the tumor suppressor VHL in kidney cancer also stabilizes HIF-1, permitting it to activate glycolytic genes, which are normally activated by HIF-1 under hypoxic conditions. HIF1 then would activate the pyruvate dehydrogenase kinase (PDKs), which inactivate the mitochondrial pyruvate dehydrogenase complex. It reduces the flow of glucose-derived pyruvate into the tricarboxylic acid (citric acid cycle or TCA cycle). This reduction in pyruvate flux into the TCA cycle decreases the rate of oxidative phosphorylation and oxygen consumption, reinforcing the glycolytic phenotype and sparing oxygen under hypoxic conditions.