Analysis of glomerulopathies in kidney neoplasms
Authors: Garkusha T. A. , Stolyarevich E. S. , Khorzhevskii V. A. , Ivliev S. V. , Firsov M. A. 
Published: March 2024

Background. Malignant neoplasms, including those of the kidneys, are widespread in the world. The main treatment for kidney tumors is surgery, one of its options is nephrectomy. Malignant tumors of various localizations can lead to a variety of kidney damage. Glomerulopathies of various origins are often asymptomatic, and therefore, patients do not seek medical help. For the diagnosis of glomerulopathies, it is necessary to assess morphological changes with the formulation of an immunofluorescence reaction and electron microscopy.

The aim: to analyze the clinical manifestations, frequency and structure of glomerulopathies in kidney neoplasms.

Patients and Methods. The study included 141 patients. The patients underwent nephrectomy, the daily protein loss, the number of altered erythrocytes in the urine, the level of creatinine in the blood serum were determined, and the glomerular filtration rate (CKD-EPI) was calculated. Morphological evaluation of samples included immunofluorescence reaction and electron microscopy. To assess the statistical significance of the relationship between variables, Spearman's nonparametric rank correlation coefficient (Rs) was calculated. The results obtained were considered significant at p<0.05. RESULTS. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies. CONCLUSION. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage the patient by an oncologist and a nephrologist Keywords: tumor, glomerulonephritis, diabetic nephropathy, glomerular filtration rate> ˂ 0.05.

Results. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies.

Conclusion. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage the patient by an oncologist and a nephrologist.