Chronic kidney cortical damage is associated with baseline kidney function and albuminuria in patients managed with radical nephrectomy for kidney tumours

Robert J. Ellis, Benjamin Kalma, Sharon J. Del Vecchio, Danielle N. Aliano, Keng Lim Ng, Goce Dimeski, Li Ma, David Guard, John F. Bertram, Christudas Morais, Kimberley Oliver, Simon T. Wood, Glenda C Gobe, Ross S. Francis

Research output: Contribution to journalArticleResearchpeer-review

Abstract

This study evaluated the relationship between histological markers of chronic kidney damage in patients undergoing radical nephrectomy for kidney tumours and preoperative kidney function, degree of albuminuria, and changes in glomerular volume. A schema to grade chronic kidney damage could be used to identify patients at risk of developing CKD following nephrectomy. Non-neoplastic cortical tissue was sourced from 150 patients undergoing radical nephrectomy for suspected kidney cancer. This tissue was evaluated for indicators of chronic damage, specifically: glomerulosclerosis, arteriosclerosis, interstitial fibrosis, and tubular atrophy. Glomerular volume was determined using the Weibel and Gomez method. Associations between these parameters and both estimated glomerular filtration rate (eGFR) and albumin-creatinine ratio (ACR) were determined using either a Mann–Whitney U-test or a Kruskal–Wallis ANOVA. Associations between both eGFR and ACR and glomerular volume were assessed using linear regression. eGFR was inversely associated with the degree of glomerulosclerosis (p < 0.001), vascular narrowing (p = 0.002), tubular atrophy (p < 0.001), and interstitial fibrosis (p < 0.001). ACR was associated only with the degree of interstitial fibrosis (p = 0.02) and tubular atrophy (p = 0.02). Glomerular volume was greater for males, diabetics, hypertensive patients, and patients with a greater degree of interstitial fibrosis. Glomerular volume was positively associated with ACR. A schema to grade chronic damage was developed. The proposed schema is associated with baseline clinical indices of kidney function and damage. Longitudinal validation is necessary to determine the prognostic utility of this schema.

Original languageEnglish
Pages (from-to)32-38
Number of pages7
JournalPathology
Volume51
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • arteriosclerosis
  • glomerulosclerosis
  • Radical nephrectomy
  • renal cell carcinoma
  • tubulointerstitial fibrosis

Cite this

Ellis, Robert J. ; Kalma, Benjamin ; Del Vecchio, Sharon J. ; Aliano, Danielle N. ; Ng, Keng Lim ; Dimeski, Goce ; Ma, Li ; Guard, David ; Bertram, John F. ; Morais, Christudas ; Oliver, Kimberley ; Wood, Simon T. ; Gobe, Glenda C ; Francis, Ross S. . / Chronic kidney cortical damage is associated with baseline kidney function and albuminuria in patients managed with radical nephrectomy for kidney tumours. In: Pathology. 2019 ; Vol. 51, No. 1. pp. 32-38.
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title = "Chronic kidney cortical damage is associated with baseline kidney function and albuminuria in patients managed with radical nephrectomy for kidney tumours",
abstract = "This study evaluated the relationship between histological markers of chronic kidney damage in patients undergoing radical nephrectomy for kidney tumours and preoperative kidney function, degree of albuminuria, and changes in glomerular volume. A schema to grade chronic kidney damage could be used to identify patients at risk of developing CKD following nephrectomy. Non-neoplastic cortical tissue was sourced from 150 patients undergoing radical nephrectomy for suspected kidney cancer. This tissue was evaluated for indicators of chronic damage, specifically: glomerulosclerosis, arteriosclerosis, interstitial fibrosis, and tubular atrophy. Glomerular volume was determined using the Weibel and Gomez method. Associations between these parameters and both estimated glomerular filtration rate (eGFR) and albumin-creatinine ratio (ACR) were determined using either a Mann–Whitney U-test or a Kruskal–Wallis ANOVA. Associations between both eGFR and ACR and glomerular volume were assessed using linear regression. eGFR was inversely associated with the degree of glomerulosclerosis (p < 0.001), vascular narrowing (p = 0.002), tubular atrophy (p < 0.001), and interstitial fibrosis (p < 0.001). ACR was associated only with the degree of interstitial fibrosis (p = 0.02) and tubular atrophy (p = 0.02). Glomerular volume was greater for males, diabetics, hypertensive patients, and patients with a greater degree of interstitial fibrosis. Glomerular volume was positively associated with ACR. A schema to grade chronic damage was developed. The proposed schema is associated with baseline clinical indices of kidney function and damage. Longitudinal validation is necessary to determine the prognostic utility of this schema.",
keywords = "arteriosclerosis, glomerulosclerosis, Radical nephrectomy, renal cell carcinoma, tubulointerstitial fibrosis",
author = "Ellis, {Robert J.} and Benjamin Kalma and {Del Vecchio}, {Sharon J.} and Aliano, {Danielle N.} and Ng, {Keng Lim} and Goce Dimeski and Li Ma and David Guard and Bertram, {John F.} and Christudas Morais and Kimberley Oliver and Wood, {Simon T.} and Gobe, {Glenda C} and Francis, {Ross S.}",
year = "2019",
month = "1",
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doi = "10.1016/j.pathol.2018.10.009",
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Ellis, RJ, Kalma, B, Del Vecchio, SJ, Aliano, DN, Ng, KL, Dimeski, G, Ma, L, Guard, D, Bertram, JF, Morais, C, Oliver, K, Wood, ST, Gobe, GC & Francis, RS 2019, 'Chronic kidney cortical damage is associated with baseline kidney function and albuminuria in patients managed with radical nephrectomy for kidney tumours' Pathology, vol. 51, no. 1, pp. 32-38. https://doi.org/10.1016/j.pathol.2018.10.009

Chronic kidney cortical damage is associated with baseline kidney function and albuminuria in patients managed with radical nephrectomy for kidney tumours. / Ellis, Robert J.; Kalma, Benjamin; Del Vecchio, Sharon J.; Aliano, Danielle N.; Ng, Keng Lim; Dimeski, Goce; Ma, Li; Guard, David; Bertram, John F.; Morais, Christudas; Oliver, Kimberley; Wood, Simon T.; Gobe, Glenda C; Francis, Ross S. .

In: Pathology, Vol. 51, No. 1, 01.01.2019, p. 32-38.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Chronic kidney cortical damage is associated with baseline kidney function and albuminuria in patients managed with radical nephrectomy for kidney tumours

AU - Ellis, Robert J.

AU - Kalma, Benjamin

AU - Del Vecchio, Sharon J.

AU - Aliano, Danielle N.

AU - Ng, Keng Lim

AU - Dimeski, Goce

AU - Ma, Li

AU - Guard, David

AU - Bertram, John F.

AU - Morais, Christudas

AU - Oliver, Kimberley

AU - Wood, Simon T.

AU - Gobe, Glenda C

AU - Francis, Ross S.

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N2 - This study evaluated the relationship between histological markers of chronic kidney damage in patients undergoing radical nephrectomy for kidney tumours and preoperative kidney function, degree of albuminuria, and changes in glomerular volume. A schema to grade chronic kidney damage could be used to identify patients at risk of developing CKD following nephrectomy. Non-neoplastic cortical tissue was sourced from 150 patients undergoing radical nephrectomy for suspected kidney cancer. This tissue was evaluated for indicators of chronic damage, specifically: glomerulosclerosis, arteriosclerosis, interstitial fibrosis, and tubular atrophy. Glomerular volume was determined using the Weibel and Gomez method. Associations between these parameters and both estimated glomerular filtration rate (eGFR) and albumin-creatinine ratio (ACR) were determined using either a Mann–Whitney U-test or a Kruskal–Wallis ANOVA. Associations between both eGFR and ACR and glomerular volume were assessed using linear regression. eGFR was inversely associated with the degree of glomerulosclerosis (p < 0.001), vascular narrowing (p = 0.002), tubular atrophy (p < 0.001), and interstitial fibrosis (p < 0.001). ACR was associated only with the degree of interstitial fibrosis (p = 0.02) and tubular atrophy (p = 0.02). Glomerular volume was greater for males, diabetics, hypertensive patients, and patients with a greater degree of interstitial fibrosis. Glomerular volume was positively associated with ACR. A schema to grade chronic damage was developed. The proposed schema is associated with baseline clinical indices of kidney function and damage. Longitudinal validation is necessary to determine the prognostic utility of this schema.

AB - This study evaluated the relationship between histological markers of chronic kidney damage in patients undergoing radical nephrectomy for kidney tumours and preoperative kidney function, degree of albuminuria, and changes in glomerular volume. A schema to grade chronic kidney damage could be used to identify patients at risk of developing CKD following nephrectomy. Non-neoplastic cortical tissue was sourced from 150 patients undergoing radical nephrectomy for suspected kidney cancer. This tissue was evaluated for indicators of chronic damage, specifically: glomerulosclerosis, arteriosclerosis, interstitial fibrosis, and tubular atrophy. Glomerular volume was determined using the Weibel and Gomez method. Associations between these parameters and both estimated glomerular filtration rate (eGFR) and albumin-creatinine ratio (ACR) were determined using either a Mann–Whitney U-test or a Kruskal–Wallis ANOVA. Associations between both eGFR and ACR and glomerular volume were assessed using linear regression. eGFR was inversely associated with the degree of glomerulosclerosis (p < 0.001), vascular narrowing (p = 0.002), tubular atrophy (p < 0.001), and interstitial fibrosis (p < 0.001). ACR was associated only with the degree of interstitial fibrosis (p = 0.02) and tubular atrophy (p = 0.02). Glomerular volume was greater for males, diabetics, hypertensive patients, and patients with a greater degree of interstitial fibrosis. Glomerular volume was positively associated with ACR. A schema to grade chronic damage was developed. The proposed schema is associated with baseline clinical indices of kidney function and damage. Longitudinal validation is necessary to determine the prognostic utility of this schema.

KW - arteriosclerosis

KW - glomerulosclerosis

KW - Radical nephrectomy

KW - renal cell carcinoma

KW - tubulointerstitial fibrosis

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