{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T13:14:29Z","timestamp":1778073269168,"version":"3.51.4"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) and renal cell carcinoma share a bidirectional relationship, with radical nephrectomy posing a significant risk for postoperative renal decline. This study identifies radical nephrectomy as a critical opportunity to evaluate the non-neoplastic renal parenchyma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational study on 30 adult patients diagnosed with renal or urothelial cancer who underwent radical nephrectomy. Samples of non-neoplastic renal parenchyma were collected during surgery and analyzed using optical microscopy and immunofluorescence. Renal function was assessed pre- and postoperatively using the CKD-EPI formula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort comprised 30 patients (63.3% male) with a median age of 65.5 years (min 29\u2013max 83). Following radical nephrectomy, 50% of patients with preserved preoperative renal function experienced a decline to estimated glomerular filtration rate\u00a0&amp;lt;\u00a060\u00a0ml\/min\/1.73 m\u00b2. Histopathological evaluation of the non-neoplastic parenchyma revealed chronic tubulointerstitial damage in 41% (n\u00a0=\u00a012) and arteriosclerotic vascular damage in 38% (n\u00a0=\u00a011) of cases. Notably, occult nephropathies were identified in 24% (n\u00a0=\u00a07) of the cohort, comprising diabetic glomerulosclerosis (n\u00a0=\u00a02), membranous nephropathy (n\u00a0=\u00a02), fibrillary glomerulonephritis (n\u00a0=\u00a01), IgA nephropathy (n\u00a0=\u00a01), and minimal change disease (n\u00a0=\u00a01). Two cases (IgA nephropathy and minimal change disease) demonstrated spontaneous remission postsurgery, consistent with a paraneoplastic etiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The non-neoplastic renal parenchyma in renal cell carcinoma patients frequently exhibits occult pathological changes, predominantly tubulointerstitial damage likely driven by the tumor microenvironment. The study highlights a higher-than-expected prevalence of undiagnosed nephropathies (24%), including paraneoplastic cases. Routine histological evaluation during radical nephrectomy is essential for optimizing patient management, avoiding unnecessary subsequent biopsies, and guiding therapeutic decisions in the oncological setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfag122","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:28:51Z","timestamp":1776770931000},"source":"Crossref","is-referenced-by-count":0,"title":["Unveiling the silent burden: high prevalence of occult nephropathies in radical nephrectomy specimens"],"prefix":"10.1093","volume":"19","author":[{"given":"Roberta","family":"Fenoglio","sequence":"first","affiliation":[{"name":"\u00a0University Center of Excellence on Nephrological, Rheumatological and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) including Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), San Giovanni Bosco Hub Hospital, ASL Citt\u00e0 di Torino and Department of Clinical and Biological Sciences of the University of Turin , Turin ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Mantovani","sequence":"additional","affiliation":[{"name":"\u00a0University Center of Excellence on Nephrological, Rheumatological and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) including Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), San Giovanni Bosco Hub Hospital, ASL Citt\u00e0 di Torino and Department of Clinical and Biological Sciences of the University of Turin , Turin 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,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Graziano","sequence":"additional","affiliation":[{"name":"Urologia, PO San Giovanni Bosco , Torino ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Bardari","sequence":"additional","affiliation":[{"name":"Urologia, PO San Giovanni Bosco , Torino ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-9441","authenticated-orcid":false,"given":"Savino","family":"Sciascia","sequence":"additional","affiliation":[{"name":"\u00a0University Center of Excellence on Nephrological, Rheumatological and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) including Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), San Giovanni Bosco Hub Hospital, ASL Citt\u00e0 di Torino and Department of Clinical and Biological Sciences of the University of Turin , Turin ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"Roccatello","sequence":"additional","affiliation":[{"name":"\u00a0University Center of Excellence on Nephrological, Rheumatological and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) including Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), San Giovanni Bosco Hub Hospital, ASL Citt\u00e0 di Torino and Department of Clinical and Biological Sciences of the University of Turin , Turin 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