Pathologic evaluation of non-neoplastic renal parenchyma in partial nephrectomy specimens

Michael Garcia-Roig, Michael A. Gorin, Carlos Parra-Herran, Monica Garcia-Buitrago, Bruce Kava, Merce Jorda, Mark S. Soloway, Murugesan Manoharan, Gaetano Ciancio

Research output: Contribution to journalArticle

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Abstract

Purpose: This study aimed to identify non-neoplastic pathologic changes in partial nephrectomy specimens of patients without a known history of medical comorbidities. Routine analysis of this tissue may allow the clinician to identify subclinical renal disease. Methods: We retrospectively reviewed our database of patients who underwent open partial nephrectomy for a small renal mass. Non-neoplastic tissue of partial nephrectomy specimens of patients without a known history of chronic kidney disease, diabetes mellitus, hypertension, or coronary artery disease was evaluated for glomerular, interstitial, and vascular pathologic changes. Results: A rim of non-neoplastic tissue was adequate for pathologic evaluation in 91.8% of specimens. A total of 45 patients were studied with a median age of 52.0 years. Atherosclerosis was the most commonly identified pathologic finding in 9 (20%) patients, followed by mesangial expansion and interstitial fibrosis, each found in 8 (17.8%) patients. Linear regression found interstitial fibrosis to be the only pathologic lesion associated with preoperative serum creatinine (coefficient = 0.697, P = 0.001). Male gender was also associated with a higher preoperative creatinine (coefficient = 0.270, P = 0.034). Postoperative serum creatinine was not associated with any of the examined lesions. Conclusions: Current surgical techniques provide adequate non-neoplastic tissue for pathologic evaluation. We observed a striking degree of pathologic disease in patients without a known history of medical comorbidities. Routine inspection of the non-neoplastic parenchyma of partial nephrectomy specimens should be performed as it can alert the clinician to presence subclinical renal disease allowing for medical intervention.

Original languageEnglish
Pages (from-to)835-839
Number of pages5
JournalWorld Journal of Urology
Volume31
Issue number4
DOIs
StatePublished - Aug 1 2013

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Nephrectomy
Kidney
Creatinine
Comorbidity
Fibrosis
Serum
Chronic Renal Insufficiency
Blood Vessels
Coronary Artery Disease
Linear Models
Atherosclerosis
Diabetes Mellitus
Databases
Hypertension

Keywords

  • Partial nephrectomy
  • Pathologic evaluation
  • Renal function

ASJC Scopus subject areas

  • Urology

Cite this

Pathologic evaluation of non-neoplastic renal parenchyma in partial nephrectomy specimens. / Garcia-Roig, Michael; Gorin, Michael A.; Parra-Herran, Carlos; Garcia-Buitrago, Monica; Kava, Bruce; Jorda, Merce; Soloway, Mark S.; Manoharan, Murugesan; Ciancio, Gaetano.

In: World Journal of Urology, Vol. 31, No. 4, 01.08.2013, p. 835-839.

Research output: Contribution to journalArticle

Garcia-Roig, Michael ; Gorin, Michael A. ; Parra-Herran, Carlos ; Garcia-Buitrago, Monica ; Kava, Bruce ; Jorda, Merce ; Soloway, Mark S. ; Manoharan, Murugesan ; Ciancio, Gaetano. / Pathologic evaluation of non-neoplastic renal parenchyma in partial nephrectomy specimens. In: World Journal of Urology. 2013 ; Vol. 31, No. 4. pp. 835-839.
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N2 - Purpose: This study aimed to identify non-neoplastic pathologic changes in partial nephrectomy specimens of patients without a known history of medical comorbidities. Routine analysis of this tissue may allow the clinician to identify subclinical renal disease. Methods: We retrospectively reviewed our database of patients who underwent open partial nephrectomy for a small renal mass. Non-neoplastic tissue of partial nephrectomy specimens of patients without a known history of chronic kidney disease, diabetes mellitus, hypertension, or coronary artery disease was evaluated for glomerular, interstitial, and vascular pathologic changes. Results: A rim of non-neoplastic tissue was adequate for pathologic evaluation in 91.8% of specimens. A total of 45 patients were studied with a median age of 52.0 years. Atherosclerosis was the most commonly identified pathologic finding in 9 (20%) patients, followed by mesangial expansion and interstitial fibrosis, each found in 8 (17.8%) patients. Linear regression found interstitial fibrosis to be the only pathologic lesion associated with preoperative serum creatinine (coefficient = 0.697, P = 0.001). Male gender was also associated with a higher preoperative creatinine (coefficient = 0.270, P = 0.034). Postoperative serum creatinine was not associated with any of the examined lesions. Conclusions: Current surgical techniques provide adequate non-neoplastic tissue for pathologic evaluation. We observed a striking degree of pathologic disease in patients without a known history of medical comorbidities. Routine inspection of the non-neoplastic parenchyma of partial nephrectomy specimens should be performed as it can alert the clinician to presence subclinical renal disease allowing for medical intervention.

AB - Purpose: This study aimed to identify non-neoplastic pathologic changes in partial nephrectomy specimens of patients without a known history of medical comorbidities. Routine analysis of this tissue may allow the clinician to identify subclinical renal disease. Methods: We retrospectively reviewed our database of patients who underwent open partial nephrectomy for a small renal mass. Non-neoplastic tissue of partial nephrectomy specimens of patients without a known history of chronic kidney disease, diabetes mellitus, hypertension, or coronary artery disease was evaluated for glomerular, interstitial, and vascular pathologic changes. Results: A rim of non-neoplastic tissue was adequate for pathologic evaluation in 91.8% of specimens. A total of 45 patients were studied with a median age of 52.0 years. Atherosclerosis was the most commonly identified pathologic finding in 9 (20%) patients, followed by mesangial expansion and interstitial fibrosis, each found in 8 (17.8%) patients. Linear regression found interstitial fibrosis to be the only pathologic lesion associated with preoperative serum creatinine (coefficient = 0.697, P = 0.001). Male gender was also associated with a higher preoperative creatinine (coefficient = 0.270, P = 0.034). Postoperative serum creatinine was not associated with any of the examined lesions. Conclusions: Current surgical techniques provide adequate non-neoplastic tissue for pathologic evaluation. We observed a striking degree of pathologic disease in patients without a known history of medical comorbidities. Routine inspection of the non-neoplastic parenchyma of partial nephrectomy specimens should be performed as it can alert the clinician to presence subclinical renal disease allowing for medical intervention.

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