There are unexplained geographical variations in the incidence of kidney cancer with the high rates reported in Baltic countries, as well as eastern and central Europe. Having access to a large and well-annotated collection of “tumor/non-tumor” pairs of kidney cancer patients from the Czech Republic, Romania, Serbia, UK, and Russia, we aimed to analyze the morphology of non-neoplastic renal tissue in nephrectomy specimens. By applying digital pathology, we performed a microscopic examination of 1012 frozen non-neoplastic kidney tissues from patients with renal cell carcinoma. Four components of renal parenchyma were evaluated and scored for the intensity of interstitial inflammation and fibrosis, tubular atrophy, glomerulosclerosis, and arterial wall thickening, globally called chronic renal parenchymal changes. Moderate or severe changes were observed in 54 (5.3%) of patients with predominance of occurrence in Romania (OR = 2.67, CI 1.07–6.67) and Serbia (OR = 4.37, CI 1.20–15.96) in reference to those from Russia. Further adjustment for comorbidities, tumor characteristics, and stage did not change risk estimates. In multinomial regression model, relative probability of non-glomerular changes was 5.22 times higher for Romania and Serbia compared to Russia. Our findings show that the frequency of chronic renal parenchymal changes, with the predominance of chronic interstitial nephritis pattern, in kidney cancer patients varies by country, significantly more frequent in countries located in central and southeastern Europe where the incidence of kidney cancer has been reported to be moderate to high. The observed association between these pathological features and living in certain geographic areas requires a larger population-based study to confirm this association on a large scale.

肾癌的发病率存在无法解释的地理差异，波罗的海国家以及东欧和中欧的发病率很高。通过访问来自捷克共和国、罗马尼亚、塞尔维亚、英国和俄罗斯的大量且注释清楚的“肿瘤/非肿瘤”肾癌患者对，我们的目的是分析肾癌中非肿瘤性肾组织的形态。肾切除标本。通过应用数字病理学，我们对来自肾细胞癌患者的 1012 份冷冻非肿瘤性肾组织进行了显微镜检查。对肾实质的四个组成部分进行评估，并对其间质炎症和纤维化、肾小管萎缩、肾小球硬化和动脉壁增厚（全球称为慢性肾实质变化）的强度进行评分。与俄罗斯患者相比，罗马尼亚（OR = 2.67，CI 1.07–6.67）和塞尔维亚（OR = 4.37，CI 1.20–15.96）的 54 名（5.3%）患者出现中度或严重变化。对合并症、肿瘤特征和分期的进一步调整并没有改变风险估计。在多项回归模型中，罗马尼亚和塞尔维亚非肾小球变化的相对概率是俄罗斯的 5.22 倍。我们的研究结果表明，肾癌患者的慢性肾实质变化（以慢性间质性肾炎模式为主）的频率因国家而异，据报告肾癌发病率较高的中欧和东南欧国家的发生率明显更高。中等到高。 观察到的这些病理特征与生活在某些地理区域之间的关联需要进行更大规模的基于人群的研究来大规模证实这种关联。