Pathologic characterization of renal epithelial neoplasms arising in nonfunctioning kidneys

Area of Science:

• Nephrology
• Uropathology
• Oncology

Background:

• Nonfunctioning kidneys exhibit diverse histopathology, but cancer incidence and types under new classifications are understudied.
• Limited research exists on renal neoplasms in various nonfunctioning kidney etiologies using updated WHO/ISUP classifications.

Purpose of the Study:

• To investigate the incidence and types of renal neoplasms in different categories of nonfunctioning kidneys.
• To compare cancer risks among acquired cystic kidney disease (ACKD), end-stage renal disease (ESRD), adult polycystic kidney disease (APKD), failed transplant kidney (FTK), and obstructive conditions (OCK).

Main Methods:

• Retrospective analysis of 311 nephrectomies from nonfunctioning kidneys.
• Categorization into ACKD, ESRD, APKD, FTK, and OCK groups.
• Histopathological review and classification of renal neoplasms according to WHO/ISUP guidelines.

Main Results:

• ACKD (70%) and ESRD (43%) had significantly higher cancer incidences than APKD (2%), FTK (0%), and OCK (5%).
• Clear cell papillary RCC and ACKD-associated RCC were more prevalent in ACKD patients.
• ACKD patients showed a higher risk for specific RCC subtypes compared to ESRD patients, despite similar risks for clear cell and papillary RCC.

Conclusions:

• Clinicopathological classification of nonfunctioning kidneys is crucial for predicting kidney cancer risk.
• Active monitoring and timely surgical intervention are recommended for high-risk nonfunctioning kidney diseases.
• ACKD and ESRD represent significant risk factors for renal neoplasms in nonfunctioning kidneys.