{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:46:07Z","timestamp":1793411167066,"version":"4.5.0"},"reference-count":38,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:p>\n                    <jats:italic>Context<\/jats:italic>\n                    .\u2014Evaluating nontumor portions of tumor nephrectomies is useful to diagnose nonneoplastic renal disease.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    .\u2014To determine the medical renal disease frequency and to assess the prognostic significance of the various renal pathologic variables with long-term follow-up in tumor nephrectomy patients.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design<\/jats:italic>\n                    .\u2014We reviewed nonneoplastic kidney sections of 456 consecutive cases from 1998 to 2008. Seventy-five cases were excluded (19 tumor compression, 25 no nonneoplastic tissue, 22 embolized kidneys, 9 end stage). Special staining, immunofluorescence, and\/or electron microscopy was performed where appropriate. Vascular sclerosis was scored from mild to severe; interstitial fibrosis\/tubular atrophy and global glomerulosclerosis (GS) were expressed as percentages. Follow-up, minimum 12 months, was evaluated in 156 cases. All renal pathologic variables were compared with regard to change in creatinine level from preoperative assessment to follow-up.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    .\u2014Of 381 cases, 57 had additional medical renal disease (15%), most frequently diabetic nephropathy (28) and hypertensive nephropathy (11). Postoperative creatinine levels increased significantly in patients with severe arteriosclerosis or arteriolosclerosis, &gt;5% GS, and &gt;10% interstitial fibrosis\/tubular atrophy. Seventy-four percent of cases with additional nonneoplastic diagnoses showed severe arteriolosclerosis. Higher corresponding GS was seen in the more affected vascular cases: mean, 5.56% GS for mild versus 23% GS for severe. Three patients progressed to renal failure 1 to 4 years after nephrectomy, 2 with hypertensive nephrosclerosis and 1 with diabetic nephropathy.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    .\u2014Medical renal disease was identified in 15% of tumor nephrectomy specimens. The degrees of vascular sclerosis, GS, and interstitial fibrosis\/tubular atrophy are predictive of elevated creatinine levels in postnephrectomy patients. Prognostic implications of the nontumor pathology are important in nephrectomized patients.\n                  <\/jats:p>","DOI":"10.5858\/arpa.2012-0070-oa","type":"journal-article","created":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T16:29:13Z","timestamp":1364833753000},"page":"531-540","source":"Crossref","is-referenced-by-count":51,"title":["Nonneoplastic Renal Cortical Scarring at Tumor Nephrectomy Predicts Decline in Kidney Function"],"prefix":"10.5858","volume":"137","author":[{"given":"Steven P.","family":"Salvatore","sequence":"first","affiliation":[{"name":"From the Departments of Pathology and Laboratory Medicine (Drs Salvatore and Seshan) and Urology (Drs Cha and Rosoff), Weill Cornell Medical College, New York, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene K.","family":"Cha","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology and Laboratory Medicine (Drs Salvatore and Seshan) and Urology (Drs Cha and Rosoff), Weill Cornell Medical College, New York, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Rosoff","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology and Laboratory Medicine (Drs Salvatore and Seshan) and Urology (Drs Cha and Rosoff), Weill Cornell Medical College, New York, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surya V.","family":"Seshan","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology and Laboratory Medicine (Drs Salvatore and Seshan) and Urology (Drs Cha and Rosoff), Weill Cornell Medical College, New York, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"9","key":"i1543-2165-137-4-531-b01","series-title":"Lancet Oncol","first-page":"735","article-title":"Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study","volume":"7","author":"Huang\n              WC,","year":"2006","unstructured":"Huang\n              WC, \n            \n              Levey\n              AS, \n            \n              Serio\n              AM, \n            et al\n          . 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J Urol. 2010;184(5):1872\u20131876."},{"issue":"11","key":"i1543-2165-137-4-531-b03","series-title":"Am J Surg Pathol","first-page":"1703","article-title":"Non-neoplastic renal diseases are often unrecognized in adult tumor nephrectomy specimens: a review of 246 cases","volume":"31","author":"Henriksen\n              KJ,","year":"2007","unstructured":"Henriksen\n              KJ, \n            \n              Meehan\n              SM, \n            \n              Chang\n              A. \n          \n          Non-neoplastic renal diseases are often unrecognized in adult tumor nephrectomy specimens: a review of 246 cases. Am J Surg Pathol. 2007;31(11):1703\u20131708."},{"issue":"5","key":"i1543-2165-137-4-531-b04","series-title":"Am J Surg Pathol","first-page":"575","article-title":"Evaluation of the nonneoplastic pathology in tumor nephrectomy specimens: predicting the risk of progressive renal failure","volume":"30","author":"Bijol\n              V,","year":"2006","unstructured":"Bijol\n              V, \n            \n              Mendez\n              GP, \n            \n              Hurwitz\n              S, \n            \n              Rennke\n              HG, \n            \n              Nose\n              V. \n          \n          Evaluation of the nonneoplastic pathology in tumor nephrectomy specimens: predicting the risk of progressive renal failure. Am J Surg Pathol. 2006;30(5):575\u2013584."},{"issue":"1","key":"i1543-2165-137-4-531-b05","series-title":"J Urol","first-page":"120","article-title":"The predictors of renal function 6 years after unilateral nephrectomy using preoperative risk factors","volume":"171","author":"Ito\n              K,","year":"2004","unstructured":"Ito\n              K, \n            \n              Nakashima\n              J, \n            \n              Hanawa\n              Y, \n            et al\n          . The predictors of renal function 6 years after unilateral nephrectomy using preoperative risk factors. J Urol. 2004;171(1):120\u2013125."},{"issue":"1","key":"i1543-2165-137-4-531-b06","series-title":"J Urol","first-page":"55","article-title":"Partial nephrectomy versus radical nephrectomy in patients with small renal tumors\u2014is there a difference in mortality and cardiovascular outcomes?","volume":"181","author":"Huang\n              WC,","year":"2009","unstructured":"Huang\n              WC, \n            \n              Elkin\n              EB, \n            \n              Levey\n              AS, \n            \n              Jang\n              TL, \n            \n              Russo\n              P. \n          \n          Partial nephrectomy versus radical nephrectomy in patients with small renal tumors\u2014is there a difference in mortality and cardiovascular outcomes?\n          J Urol. 2009;181(1):55\u201362."},{"issue":"1","key":"i1543-2165-137-4-531-b07","series-title":"J Urol","first-page":"43","article-title":"Chronic kidney disease before and after partial nephrectomy","volume":"185","author":"Clark\n              MA,","year":"2011","unstructured":"Clark\n              MA, \n            \n              Shikanov\n              S, \n            \n              Raman\n              JD, \n            et al\n          . Chronic kidney disease before and after partial nephrectomy. J Urol. 2011;185(1):43\u201348."},{"key":"i1543-2165-137-4-531-b08","series-title":"World J Urol","article-title":"Pathologic evaluation of non-neoplastic renal parenchyma in partial nephrectomy specimens","author":"Garcia-Roig\n              M,","year":"2011","unstructured":"Garcia-Roig\n              M, \n            \n              Gorin\n              MA, \n            \n              Parra-Herran\n              C, \n            et al\n          . Pathologic evaluation of non-neoplastic renal parenchyma in partial nephrectomy specimens. World J Urol. 2011."},{"issue":"2","key":"i1543-2165-137-4-531-b09","series-title":"Arch Pathol Lab Med","first-page":"189","article-title":"Diagnosing nonneoplastic lesions in nephrectomy specimens","volume":"133","author":"Truong\n              LD,","year":"2009","unstructured":"Truong\n              LD, \n            \n              Shen\n              SS, \n            \n              Park\n              M-H, \n            \n              Krishnan\n              B. \n          \n          Diagnosing nonneoplastic lesions in nephrectomy specimens. Arch Pathol Lab Med. 2009;133(2):189\u2013200."},{"issue":"4","key":"i1543-2165-137-4-531-b10","series-title":"J Am Soc Nephrol","first-page":"556","article-title":"Pathologic classification of diabetic nephropathy","volume":"21","author":"Tervaert\n              TW,","year":"2010","unstructured":"Tervaert\n              TW, \n            \n              Mooyaart\n              AL, \n            \n              Amann\n              K, \n            et al\n          . Pathologic classification of diabetic nephropathy. J Am Soc Nephrol. 2010;21(4):556\u2013563."},{"issue":"5","key":"i1543-2165-137-4-531-b11","series-title":"Am J Clin Pathol","first-page":"623","article-title":"Recommendations for the reporting of surgically resected specimens of renal cell carcinoma","volume":"131","year":"2009","unstructured":"Association of Directors of Anatomic and Surgical Pathology. Recommendations for the reporting of surgically resected specimens of renal cell carcinoma. Am J Clin Pathol. 2009;131(5):623\u2013630."},{"issue":"6","key":"i1543-2165-137-4-531-b12","series-title":"J Am Soc Nephrol","first-page":"1315","article-title":"Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation","volume":"12","author":"Hostetter\n              TH,","year":"2001","unstructured":"Hostetter\n              TH, \n            \n              Olson\n              JL, \n            \n              Rennke\n              HG, \n            \n              Venkatachalam\n              MA, \n            \n              Brenner\n              BM. \n          \n          Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. J Am Soc Nephrol. 2001;12(6):1315\u20131325."},{"issue":"6","key":"i1543-2165-137-4-531-b13","series-title":"J Am Soc Nephrol","first-page":"898","article-title":"The clinical importance of nephron mass","volume":"21","author":"Luyckx\n              VA,","year":"2010","unstructured":"Luyckx\n              VA, \n            \n              Brenner\n              BM. \n          \n          The clinical importance of nephron mass. J Am Soc Nephrol. 2010;21(6):898\u2013910."},{"issue":"15","key":"i1543-2165-137-4-531-b14","series-title":"N Engl J Med","first-page":"1058","article-title":"Long-term follow-up after partial removal of a solitary kidney","volume":"325","author":"Novick\n              AC,","year":"1991","unstructured":"Novick\n              AC, \n            \n              Gephardt\n              G, \n            \n              Guz\n              B, \n            \n              Steinmuller\n              D, \n            \n              Tubbs\n              RR. \n          \n          Long-term follow-up after partial removal of a solitary kidney. N Engl J Med. 1991;325(15):1058\u20131062."},{"issue":"4","key":"i1543-2165-137-4-531-b15","series-title":"J Urol","first-page":"1317","article-title":"Nephrectomy induced chronic renal insufficiency is associated with increased risk of cardiovascular death and death from any cause in patients with localized cT1b renal masses","volume":"183","author":"Weight\n              CJ,","year":"2010","unstructured":"Weight\n              CJ, \n            \n              Larson\n              BT, \n            \n              Fergany\n              AF, \n            et al\n          . Nephrectomy induced chronic renal insufficiency is associated with increased risk of cardiovascular death and death from any cause in patients with localized cT1b renal masses. J Urol. 2010;183(4):1317\u20131323."},{"issue":"8","key":"i1543-2165-137-4-531-b16","series-title":"J Am Soc Nephrol","first-page":"1106","article-title":"Aging and the kidney","volume":"7","author":"Epstein\n              M.","year":"1996","unstructured":"Epstein\n              M. \n          \n          Aging and the kidney. J Am Soc Nephrol. 1996;7(8):1106\u20131122."},{"issue":"1","key":"i1543-2165-137-4-531-b17","series-title":"Diabetologia","first-page":"107","article-title":"The role of diabetes mellitus in the aetiology of renal cell cancer","volume":"42","author":"Lindblad\n              P,","year":"1999","unstructured":"Lindblad\n              P, \n            \n              Chow\n              W, \n            \n              Chan\n              J, \n            et al\n          . The role of diabetes mellitus in the aetiology of renal cell cancer. Diabetologia. 1999;42(1):107\u2013112."},{"issue":"2","key":"i1543-2165-137-4-531-b18","series-title":"Arch Pathol Lab Med","first-page":"138","article-title":"Renal cell neoplasms: their relationship to arteriolonephrosclerosis","volume":"108","author":"Budin\n              R.","year":"1984","unstructured":"Budin\n              R. \n            \n              McDonnell\n              PJ. \n          \n          Renal cell neoplasms: their relationship to arteriolonephrosclerosis. Arch Pathol Lab Med. 1984;108(2):138\u2013141."},{"issue":"4","key":"i1543-2165-137-4-531-b19","series-title":"Arthritis Rheum","first-page":"751","article-title":"Wegener's granulomatosis associated with renal cell carcinoma","volume":"42","author":"Tatsis\n              E,","year":"1999","unstructured":"Tatsis\n              E, \n            \n              Reinhold-Keller\n              E, \n            \n              Steindort\n              K, \n            \n              Feller\n              AC, \n            \n              Gross\n              WL. \n          \n          Wegener's granulomatosis associated with renal cell carcinoma. Arthritis Rheum. 1999;42(4):751\u2013756."},{"issue":"9","key":"i1543-2165-137-4-531-b01","series-title":"Lancet Oncol","first-page":"735","article-title":"Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study","volume":"7","author":"Huang\n              WC,","year":"2006","unstructured":"Huang\n              WC, \n            \n              Levey\n              AS, \n            \n              Serio\n              AM, \n            et al\n          . Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. 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Am J Surg Pathol. 2007;31(11):1703\u20131708."},{"issue":"5","key":"i1543-2165-137-4-531-b04","series-title":"Am J Surg Pathol","first-page":"575","article-title":"Evaluation of the nonneoplastic pathology in tumor nephrectomy specimens: predicting the risk of progressive renal failure","volume":"30","author":"Bijol\n              V,","year":"2006","unstructured":"Bijol\n              V, \n            \n              Mendez\n              GP, \n            \n              Hurwitz\n              S, \n            \n              Rennke\n              HG, \n            \n              Nose\n              V. \n          \n          Evaluation of the nonneoplastic pathology in tumor nephrectomy specimens: predicting the risk of progressive renal failure. Am J Surg Pathol. 2006;30(5):575\u2013584."},{"issue":"1","key":"i1543-2165-137-4-531-b05","series-title":"J Urol","first-page":"120","article-title":"The predictors of renal function 6 years after unilateral nephrectomy using preoperative risk factors","volume":"171","author":"Ito\n              K,","year":"2004","unstructured":"Ito\n              K, \n            \n              Nakashima\n              J, \n            \n              Hanawa\n              Y, \n            et al\n          . The predictors of renal function 6 years after unilateral nephrectomy using preoperative risk factors. J Urol. 2004;171(1):120\u2013125."},{"issue":"1","key":"i1543-2165-137-4-531-b06","series-title":"J Urol","first-page":"55","article-title":"Partial nephrectomy versus radical nephrectomy in patients with small renal tumors\u2014is there a difference in mortality and cardiovascular outcomes?","volume":"181","author":"Huang\n              WC,","year":"2009","unstructured":"Huang\n              WC, \n            \n              Elkin\n              EB, \n            \n              Levey\n              AS, \n            \n              Jang\n              TL, \n            \n              Russo\n              P. \n          \n          Partial nephrectomy versus radical nephrectomy in patients with small renal tumors\u2014is there a difference in mortality and cardiovascular outcomes?\n          J Urol. 2009;181(1):55\u201362."},{"issue":"1","key":"i1543-2165-137-4-531-b07","series-title":"J Urol","first-page":"43","article-title":"Chronic kidney disease before and after partial nephrectomy","volume":"185","author":"Clark\n              MA,","year":"2011","unstructured":"Clark\n              MA, \n            \n              Shikanov\n              S, \n            \n              Raman\n              JD, \n            et al\n          . Chronic kidney disease before and after partial nephrectomy. J Urol. 2011;185(1):43\u201348."},{"key":"i1543-2165-137-4-531-b08","series-title":"World J Urol","article-title":"Pathologic evaluation of non-neoplastic renal parenchyma in partial nephrectomy specimens","author":"Garcia-Roig\n              M,","year":"2011","unstructured":"Garcia-Roig\n              M, \n            \n              Gorin\n              MA, \n            \n              Parra-Herran\n              C, \n            et al\n          . Pathologic evaluation of non-neoplastic renal parenchyma in partial nephrectomy specimens. World J Urol. 2011."},{"issue":"2","key":"i1543-2165-137-4-531-b09","series-title":"Arch Pathol Lab Med","first-page":"189","article-title":"Diagnosing nonneoplastic lesions in nephrectomy specimens","volume":"133","author":"Truong\n              LD,","year":"2009","unstructured":"Truong\n              LD, \n            \n              Shen\n              SS, \n            \n              Park\n              M-H, \n            \n              Krishnan\n              B. \n          \n          Diagnosing nonneoplastic lesions in nephrectomy specimens. Arch Pathol Lab Med. 2009;133(2):189\u2013200."},{"issue":"4","key":"i1543-2165-137-4-531-b10","series-title":"J Am Soc Nephrol","first-page":"556","article-title":"Pathologic classification of diabetic nephropathy","volume":"21","author":"Tervaert\n              TW,","year":"2010","unstructured":"Tervaert\n              TW, \n            \n              Mooyaart\n              AL, \n            \n              Amann\n              K, \n            et al\n          . Pathologic classification of diabetic nephropathy. J Am Soc Nephrol. 2010;21(4):556\u2013563."},{"issue":"5","key":"i1543-2165-137-4-531-b11","series-title":"Am J Clin Pathol","first-page":"623","article-title":"Recommendations for the reporting of surgically resected specimens of renal cell carcinoma","volume":"131","year":"2009","unstructured":"Association of Directors of Anatomic and Surgical Pathology. Recommendations for the reporting of surgically resected specimens of renal cell carcinoma. Am J Clin Pathol. 2009;131(5):623\u2013630."},{"issue":"6","key":"i1543-2165-137-4-531-b12","series-title":"J Am Soc Nephrol","first-page":"1315","article-title":"Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation","volume":"12","author":"Hostetter\n              TH,","year":"2001","unstructured":"Hostetter\n              TH, \n            \n              Olson\n              JL, \n            \n              Rennke\n              HG, \n            \n              Venkatachalam\n              MA, \n            \n              Brenner\n              BM. \n          \n          Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. J Am Soc Nephrol. 2001;12(6):1315\u20131325."},{"issue":"6","key":"i1543-2165-137-4-531-b13","series-title":"J Am Soc Nephrol","first-page":"898","article-title":"The clinical importance of nephron mass","volume":"21","author":"Luyckx\n              VA,","year":"2010","unstructured":"Luyckx\n              VA, \n            \n              Brenner\n              BM. \n          \n          The clinical importance of nephron mass. J Am Soc Nephrol. 2010;21(6):898\u2013910."},{"issue":"15","key":"i1543-2165-137-4-531-b14","series-title":"N Engl J Med","first-page":"1058","article-title":"Long-term follow-up after partial removal of a solitary kidney","volume":"325","author":"Novick\n              AC,","year":"1991","unstructured":"Novick\n              AC, \n            \n              Gephardt\n              G, \n            \n              Guz\n              B, \n            \n              Steinmuller\n              D, \n            \n              Tubbs\n              RR. \n          \n          Long-term follow-up after partial removal of a solitary kidney. N Engl J Med. 1991;325(15):1058\u20131062."},{"issue":"4","key":"i1543-2165-137-4-531-b15","series-title":"J Urol","first-page":"1317","article-title":"Nephrectomy induced chronic renal insufficiency is associated with increased risk of cardiovascular death and death from any cause in patients with localized cT1b renal masses","volume":"183","author":"Weight\n              CJ,","year":"2010","unstructured":"Weight\n              CJ, \n            \n              Larson\n              BT, \n            \n              Fergany\n              AF, \n            et al\n          . Nephrectomy induced chronic renal insufficiency is associated with increased risk of cardiovascular death and death from any cause in patients with localized cT1b renal masses. J Urol. 2010;183(4):1317\u20131323."},{"issue":"8","key":"i1543-2165-137-4-531-b16","series-title":"J Am Soc Nephrol","first-page":"1106","article-title":"Aging and the kidney","volume":"7","author":"Epstein\n              M.","year":"1996","unstructured":"Epstein\n              M. \n          \n          Aging and the kidney. J Am Soc Nephrol. 1996;7(8):1106\u20131122."},{"issue":"1","key":"i1543-2165-137-4-531-b17","series-title":"Diabetologia","first-page":"107","article-title":"The role of diabetes mellitus in the aetiology of renal cell cancer","volume":"42","author":"Lindblad\n              P,","year":"1999","unstructured":"Lindblad\n              P, \n            \n              Chow\n              W, \n            \n              Chan\n              J, \n            et al\n          . The role of diabetes mellitus in the aetiology of renal cell cancer. 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Arch Pathol Lab Med. 1984;108(2):138\u2013141."},{"issue":"4","key":"i1543-2165-137-4-531-b19","series-title":"Arthritis Rheum","first-page":"751","article-title":"Wegener's granulomatosis associated with renal cell carcinoma","volume":"42","author":"Tatsis\n              E,","year":"1999","unstructured":"Tatsis\n              E, \n            \n              Reinhold-Keller\n              E, \n            \n              Steindort\n              K, \n            \n              Feller\n              AC, \n            \n              Gross\n              WL. \n          \n          Wegener's granulomatosis associated with renal cell carcinoma. 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