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Abstract: PO2249

Prevalence and Risk Factors Associated with Nephrosclerosis in Renal Parenchyma Specimens of Patients Undergoing Partial or Radical Nephrectomy

Session Information

Category: Pathology and Lab Medicine

  • 1602 Pathology and Lab Medicine: Clinical

Authors

  • Salcedo Betancourt, Juan David, University of Miami School of Medicine, Miami, Florida, United States
  • Goodrich, Kenny Alexander, University of Miami School of Medicine, Miami, Florida, United States
  • Iakymenko, Oleksii, University of Miami School of Medicine, Miami, Florida, United States
  • Rozas, Jhoan B., University of Miami School of Medicine, Miami, Florida, United States
  • Philips, Ragi, University of Miami School of Medicine, Miami, Florida, United States
  • Contreras, Gabriel, University of Miami School of Medicine, Miami, Florida, United States
  • Fornoni, Alessia, University of Miami School of Medicine, Miami, Florida, United States
  • Barisoni, Laura, Duke University School of Medicine, Durham, North Carolina, United States
  • Florindez, Jorge A., University of Miami School of Medicine, Miami, Florida, United States
  • Thomas, David B., IYM Health Financial Services, PLLC, Charlotte, North Carolina, United States
  • Munoz Mendoza, Jair, University of Miami School of Medicine, Miami, Florida, United States
Background

Evaluation of non-neoplastic renal parenchyma in nephrectomies is part of the College of American Pathologists (CAP) Cancer Protocols. We evaluated the prevalence of histological abnormalities and nephrosclerosis and its association with clinical factors in patients undergoing nephrectomy for any cause at our institution.

Methods

Two nephropathologists evaluated the status of the renal parenchyma in 813 patients who underwent either partial (41%) or radical nephrectomy (59%) between 2013 and 2017. Age-adjusted global glomerulosclerosis (GS), interstitial fibrosis (IF), tubular atrophy (TA), and arteriosclerosis (AS) were evaluated by light microscopy. Nephrosclerosis was defined as the presence of ≥ 2 histologic variables. Clinical, demographic, and pathological data were collected by chart review. Logistic regression analysis was used to evaluate the association between clinical parameters and nephrosclerosis.

Results

The mean age was 60 ± 14 years. 38% were female, 44% were Hispanics. 59% had hypertension, 22% had diabetes mellitus and 24% had a smoking history. The pre-nephrectomy eGFR was 73 ± 27 ml/min/1.73m2 and 31% had an eGFR <60 ml/min/1.73m2. The prevalence of age-adjusted GS was 82%, any TA was 80%, more than 5% IF was 78% and any AS was 95%. The prevalence of nephrosclerosis was 88%. Lower pre-nephrectomy eGFR (adjusted odds ratio [OR] per 10 units decrease in eGFR, 1.12 [95% confidence interval (CI), 1.02-1.23]), and age (adjusted OR per 10 years increase, 1.97 [95% CI, 1.64-2.39]) were significantly associated with nephrosclerosis. Gender, history of hypertension, diabetes, and smoking were not associated with nephrosclerosis (p>0.05 for all).

Conclusion

Nephrosclerosis is highly prevalent in renal parenchyma of patients undergoing nephrectomy. Lower pre-nephrectomy eGFR and older age were independently associated with significantly greater odds of nephrosclerosis. Future studies should evaluate the association between nephrosclerosis and post-nephrectomy eGFR.