Tumorbasierte Induktion von Glomerulonephritiden

Hoxha, Elion; Huber, Tobias B.

doi:10.1007/s11560-020-00404-y

Cited by 1 publication

(1 citation statement)

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“…Diagnosis of glomerulonephritis was associated with an accelerated eGFR decline at 12 months follow-up and was only associated with malignant renal tumors. Here, paraneoplastic glomerular disease could be postulated and this is well described for vasculitis, IgA nephropathy, membranous nephropathy, or membranoproliferative glomerulonephritis in different cancers [ 12 – 14 ]. Nevertheless, we cannot totally rule out a coincidental association.…”

Section: Discussionmentioning

confidence: 99%

More than ancillary records: clinical implications of renal pathology examination in tumor nephrectomy specimens

et al. 2021

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Background Nephrectomy is the management of choice for the treatment of renal tumors. Surgical pathologists primarily focus on tumor diagnosis and investigations relating to prognosis or therapy. Pathological changes in non-neoplastic tissue may, however, be relevant for further management and should be thoroughly assessed. Methods Here, we examined the non-neoplastic renal parenchyma in 206 tumor nephrectomy specimens for the presence of glomerular, tubulo-interstitial, or vascular lesions, and correlated them with clinical parameters and outcome of renal function. Results We analyzed 188 malignant and 18 benign or pseudo-tumorous lesions. The most common tumor type was clear cell renal cell carcinoma (CCRCC, n = 106) followed by papillary or urothelial carcinomas (n = 25). Renal pathology examination revealed the presence of kidney disease in 39 cases (18.9%). Glomerulonephritis was found in 15 cases (7.3%), and the most frequent was IgA nephropathy (n = 6; 2.9%). Vasculitis was found in two cases (0.9%). In 15 cases we found tubulo-interstitial nephritis, and in 9 severe diabetic or hypertensive nephropathy. Partial nephrectomy was not linked to better eGFR at follow-up. Age, vascular nephropathy, glomerular scarring and interstitial fibrosis were the leading independent negative factors influencing eGFR at time of surgery, whereas proteinuria was associated with reduced eGFR at 1 year. Conclusion Our large study population indicates a high incidence of renal diseases potentially relevant for the postoperative management of patients with renal neoplasia. Consistent and systematic reporting of non-neoplastic renal pathology in tumor nephrectomy specimens should therefore be mandatory.

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Section: Discussionmentioning

confidence: 99%