Histologic Abnormalities in Nonneoplasic Renal Parenchyma and the Risk of Chronic Kidney Disease Following Radical Nephrectomy

• Published in: Urology (Ridgewood, N.J.) N.J.), 2016
• Main Authors: Brandina, Ricardo, MD, Moreira Leite, Katia Ramos, MD, Gregório, Emerson Pereira, MD, Fernandes, Karen Barros Parron, Srougi, Miguel, MD
• Format: Article
• Language: English
• Subjects: Urology
• ISSN: 0090-4295
• DOI: 10.1016/j.urology.2016.09.041

Objectives To assess the association of histopathological parameters in non-neoplastic renal parenchyma with development of new onset chronic kidney disease (CKD) after radical nephrectomy. Methods Data were extracted from 222 patients who underwent radical nephrectomy. The Modification of Diet in Renal Disease (MDRD) formula was used. The study end point was development of CKD, defined as an estimated glomerular filtration rate (eGFR) of less than 60ml/minute/1,73m2 . A renal pathologist assessed three histological features in the nonneoplastic parenchyma, including global glomerulosclerosis (GS), arteriosclerosis (AS) and interstitial fibrosis (IF). For GS assessment, the percent of affected glomeruli was determined. Arteriosclerosis was graded into three groups, including 1—0% to 25%, 2—26% to 50% and 3—greater than 50%. Interstitial fibrosis was evaluated as absent/present. RESULTS: After a mean follow-up of 49,06 months, the mean eGFR rate decrease was 26,5% after radical nephrectomy. Almost half of the patients (53,8%) developed CKD. For each 2,5% increase in GS, each point increased in Charlson Comorbidity index (CCI) and each 10 years increase in pantient´s age, the eGFR decreased 28%, 33% and 39%, respectively (p