Histopathologic Correlates of Kidney Function: Insights From Nephrectomy Specimens.
Histopathologic Correlates of Kidney Function: Insights From Nephrectomy Specimens.
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肾功能的组织病理学相关性：来自肾切除标本的见解。
DOI：
10.1053/j.ajkd.2020.08.015
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
McMahon,GearoidM
中科院分区：
文献类型：
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作者：
Li,Ping;Gupta,Shruti;Mothi,SurajS;Rennke,HelmutG;Leaf,DavidE;Waikar,SushrutS;McMahon,GearoidM
现有的数据集将肾脏组织病理学发现与肾功能相关联，老年患者的比例较低（并且具有肾衰竭家族史的患者比例过高），这限制了其普遍性。我们的目的是使用来自肾切除标本的非肿瘤组织来检查组织病理学变化程度和估计的肾小球滤过率（eGFR）之间的关联，并确定该关联是否因年龄而异。和动脉硬化/动脉硬化（AS）。结果GFR。分析方法我们回顾性分析了肾脏病理报告（非肿瘤组织）来自1，347名因任何适应症（但最常见的是肾癌）接受肾切除术的患者（1999-2018）。我们评估了GS，IFTA和AS与eGFR在肾切除术时的程度之间的关联，这是否是修改的年龄.ResultsAmong的参与者（年龄17-91岁），42%和57.8%有> 10%GS和IFTA，分别为81.8%有中度或重度AS。经多变量校正后，我们发现GS、IFTA和AS程度越高，eGFR越低。虽然有更严重程度的GS和IFTA在老年人的患病率更高，各种组织病理学特征和eGFR之间的关联并没有修改由age.LimitationsRetrospective横断面study.ConclusionsOur研究表明，在不同水平的eGFR肾脏的组织学外观的差异。尽管高龄组患者晚期病变的患病率较高，但有一个亚组具有良好的肾功能和有限的组织学变化。
Rationale & ObjectiveExisting data sets correlating kidney histopathologic findings with kidney function have low proportions of elderly patients (and those with a family history of kidney failure are over-represented), which limits their generalizability. Our objective was to use non-neoplastic tissue from nephrectomy specimens to examine the association between degree of histopathologic changes and estimated glomerular filtration rate (eGFR) and determine whether the association differed by age.Study DesignCross-sectional study.ExposuresGlomerulosclerosis (GS), interstitial fibrosis/tubular atrophy (IFTA), and arterial sclerosis/arteriosclerosis (AS).OutcomeeGFR.Analytical ApproachWe retrospectively reviewed kidney pathology reports (of non-neoplastic tissue) from 1,347 patients who underwent nephrectomy (1999-2018) for any indication but most commonly due to kidney cancer. We evaluated the association between degree of GS, IFTA, and AS with eGFR at the time of nephrectomy and whether this was modified by age.ResultsAmong the participants (aged 17-91 years), 42% and 57.8% had >10% GS and IFTA, respectively, and 81.8% had moderate or severe AS. We found that greater degrees of GS, IFTA, and AS were associated with lower eGFR after multivariable adjustment. Although there was a greater prevalence of more severe degrees of GS and IFTA in older individuals, the association between various histopathologic features and eGFR was not modified by age.LimitationsRetrospective cross-sectional study.ConclusionsOur study demonstrates differences in the histologic appearance of the kidneys across levels of eGFR. Although the prevalence of advanced changes was higher in the oldest group of patients, a subset had excellent kidney function and limited histologic changes.