Spectrum of lesions in non-neoplastic nephrectomy specimens and their clinico-pathological correlation- a tertiary care hospital experience

Introduction: Nephrectomy is a common surgical procedure done in neoplastic as well as many non-neoplastic conditions affecting kidney. Poor renal functioning is a major burden contributing to nephrectomy. Materials and Methods: This is a prospective and retrospective study conducted to study the clinicopathological correlation of non-neoplastic nephrectomy specimen. The significant gross and microscopic findings were tabulated for studying the relative frequency of different non neoplastic conditions affecting the kidney. Result: In our study we found that 70 to 85 % of total nephrectomies were for non-neoplastic indications. Hydronephrosis was by far the commonest indication for nephrectomy. The peak age ranges were 31- 40 yrs and 51-60 yrs for males and 31-40 yrs for females. Both males and females showed right sided nephrectomy more common than left sided. On microscopy, the predominant finding was glomerular sclerosis in 38% of the specimens and hyalinization of the glomeruli in 23% of the cases. Chronic inflammation was by far the commonest finding with lymphocytes, plasma cells infiltrating the interstitium in all the studied specimens. It was observed that chronic pyelonephritis with end stage kidney disease and hydronephrosis were by far the commonest diagnosis offered contributing to 88% of the cases. Conclusion: Our study concludes that chronic pyelonephritis, hydronephrosis are the commonest nonneoplastic conditions contributing to the nephrectomy burden. As these are a treatable group of conditions, they should be well identified in the earlier stages so that many such nephrectomies can be avoided. Keywords: Nephrectomy, Pathology, Microscopy, Non-neoplastic.