DefinePK

Research Objective

To report single-center pathological findings in nephrectomy specimens from patients treated for non-functioning kidneys due to renal stone disease and to determine if incidental renal neoplasia is more common than previously reported.

Methodology

Retrospective review of medical records of 210 patients who underwent simple nephrectomy between 2014 and 2021 at The Kidney Centre Postgraduate Training Institute for non-functioning kidneys due to renal stone disease. Data included patient demographics and histopathology reports of nephrectomy specimens. Statistical analysis included mean and standard deviation for age, and percentages for gender and histopathology findings.

Methodology Flowchart

                        graph TD;
    A[Review Medical Records of 210 Patients] --> B[Identify Patients with Simple Nephrectomy for Non-Functioning Kidney due to Stones2014-2021];
    B --> C[Collect Patient Demographics and Histopathology Reports];
    C --> D[Analyze Data: Calculate Mean Age, Gender Percentages, Histopathology Distribution];
    D --> E[Identify Cases of Renal Malignancy];
    E --> F[Compare Findings with Existing Literature];
    F --> G[Formulate Conclusions and Recommendations];                    

Discussion

The study suggests that the prevalence of renal malignancy in non-functioning kidneys due to renal stone disease is significant. The findings indicate that RCC was more common than SCC in this cohort, contrary to some literature suggesting SCC as the most common malignancy associated with chronic inflammation from stones. The limitations of NCCT in diagnosing renal neoplasia, especially in non-functioning kidneys, are highlighted. The study emphasizes the need for prompt treatment of non-functioning kidneys with renal stones due to their potential to harbor malignancies and the importance of counseling patients about the possibility of malignancy post-histopathology.

Key Findings

- Renal malignancy was found in 10 out of 210 patients (4.76%).
- Among the malignancies, Renal Cell Carcinoma (RCC) was found in 4 specimens, Transitional Cell Carcinoma (TCC) in 3, and Squamous Cell Carcinoma (SCC) in 3.
- Chronic pyelonephritis was the most common finding (86.66%), followed by xanthogranulomatous pyelonephritis (5.23%) and tuberculosis of the kidney (3.33%).
- None of the patients with malignancy had a preoperative suspicion of renal neoplasia based on non-contrast-enhanced computed tomography (NCCT) findings.

Conclusion

The prevalence of renal malignancy in patients undergoing simple nephrectomy for non-functioning kidneys due to renal stone disease is significantly high. Non-functioning kidneys with renal stone disease should be treated with priority due to the potential for malignancy. Patients should be counseled about the possibility of renal malignancy, and imaging protocols may need development to better identify these cases.

Fact Check

- Number of patients: 210 patients underwent simple nephrectomy. (Confirmed in Results section)
- Prevalence of renal malignancy: 4.76% of patients had renal malignancy. (Confirmed in Results section and Table 1)
- Most common histopathology finding: Chronic pyelonephritis was found in 182 out of 210 patients (86.66%). (Confirmed in Results section and Table 1)

Mind Map