An analysis of adult non-neoplastic nephrectomies at a tertiary care centre in Mumbai

Abstract

Introduction: Nephrectomies are an integral part o f u rological p ractice and a wide rang e o f ren al diseas es are s een on histopathological examination o f non-n eoplastic n ephrectomy specimens. Objective: The objective o f this study was to assess the incidence, clinical presentation and the histological spectrum o f various non-neoplastic ren al diseases det ected in nephrectomy specimens at our institute and to compare our observations with the conventional patterns seen. Material and Methods: This is a retrospective 6 year study of adult non-neoplastic nephrectomies (ANNN) conduct ed in a tertiary care centre in Mumbai and includes 359 cases from January 2009 to Decemb er 2015. The paraffin blocks and slides were retriev ed from our archives and analys ed along with clinical features, radiological findings. Results: 359 ANNN specimens received ov er a 6 y ear p eriod were studied. Most of the patients were in the sixth decade with a slight female preponderance. Flank pain was the commonest presenting symptom seen in 79.94% of cas es. The most frequent surgical indication fo r ANNN was obstru ctive urop athy (47.08%) which in cludes calculus disease and PUJ obstruction followed by non-fun ctioning kidney (42.06%). On histopathological examination, the most common gross pathology was acal culus hydronephrosis (40.67%) and the most frequ ent histopathological diagnosis was chronic pyelon ephritis seen in 79.38% cases. Calculus obstructive uropathy amounted to 39.27% cases and acalculus obstructive urop athy amounted to 25.07% cases of ch ronic pyeloneph ritis. Conclusion: The most frequent surgical indication was obstructive uropathy and the most common histopathological diagnosis was chronic pyelonephritis. Calculus and acalculus obstructive uropathy amounted to almost 65% of the cases o f chronic pyeloneph ritis.