Incidental Findings of Renal Lesion in Autopsy Specimens of Kidney NotDirectly Related to the Cause of Death: A Cross-Sectional Study

Background: Autopsy studies still give rare insight into silent kidney disease, especially where imaging or screening is limited. Objective: To profile the spectrum and frequency of incidental renal lesions identified at medicolegal autopsy. Methods: A cross-sectional study using consecutive sampling was conducted between April 2017 and March 2018 at the police morgue affiliated with R. G. Kar Medical College, Kolkata. All kidneys that appeared grossly abnormal during 786 medicolegal autopsies were retrieved (n 50) and processed by standard histopathology (HE and Van Gieson). Lesions were enumerated and categorized; summary statistics were generated. Results: The 50 kidneys belonged to 34 males and 16 females (mean age SD 58.5 13.2 years. Microscopy revealed 56 separate lesions including simple cortical cysts 39 (69.6 ), granular contracted kidneys 8 (14.3 ), renal calculi 3 (5.4 ), hydronephrosis 3 (5.4 ), autosomal-dominant polycystic kidney disease 1 (1.8 ), capsular leiomyoma 1 (1.8 ), and clear-cell renal cell carcinoma 1 (1.8 ). Most simple cysts (89.7 ) lie in the cortex, and 92.3 measured under 5 cm. Five granular contracted kidneys also showed simple cysts, and one hydronephrotic kidney contained multiple stones. Conclusions: Almost seven out of ten incidental renal lesions found at autopsy were simple cysts, yet important conditions such as polycystic kidney disease, end-stage granular kidneys, and an unsuspected carcinoma were also present. Routine, careful examination of autopsy kidneys can uncover the hidden burden of renal disease and may guide future community-based screening programmes.