Abstracts - USICON 2016

Rana Birendra

CMCH, Vellore, Tamil Nadu, India

Category: Basic Sciences

Introduction: Radical nephrectomy leads to decrease in global renal functions. Aim was to find histopathological factors in non tumor bearing renal parenchyma that can help in predicting the decline in global renal function. We would also study association of other factors like diabetes (DM) and hypertension (HTN) with decline in renal function and on non tumor parenchyma.

Methods: Prospectively we collected data of 73 patients undergoing tumor nephrectomy from period December-2013 to January-2015. Non tumor parenchyma of the specimen was reported by histopathologist using periodic-acid Schiff stain. The histopathological factors evaluated were arteriosclerosis (AS) and arteriolar hylinosis (AH), glomerulosclerosis (GS) and interstitial fibrosis/tubular atrophy (IF/TA). eGFR (estimated glomerular filteration rate) was calculated using Cockcroft-Gault formula before the surgery and at last follow up of at least 6 months. Percent change in renal function was calculated as difference between preoperative eGFR and post operative eGFR/preoperative eGFR X 100.

Result: Mean follow up was 8.3 months. The mean decrease in eGFR was 22% (p = 0.0001). Percent decrease in eGFR did not show association with any of the histopathological parameters. DM was significantly associated with decrease in percent eGFR (p < 0.05) and increase in AH (p = 0.004), GS (p = 0.03) and IF/TA (p = 0.0001). Maximum size of the tumor showed a negative correlation with percentage change in eGFR (p = 0.028).

Conclusion: None of the histological parameters showed a significant association with percent eGFR change over a short follow up. Patients with DM showed significant decrease in renal function and change in non tumor parenchyma. Patient with small tumors and DM would benefit from nephron sparing surgeries to preserve global renal function.