CKD Risk Higher with Radical Nephrectomy
New-onset chronic kidney disease (CKD) is more likely to develop in patients who undergo radical nephrectomy (RN) than partial nephrectomy (PN), according to a new study.
Elin Mariusdottir, MD, and collaborators at Landspitali University Hospital in Reykjavik, Iceland, compared 44 patients with renal cell carcinoma (RCC) who underwent PN and 44 matched controls who underwent RN.
The groups were similar with respect to preoperative estimated glomerular filtration rate (eGFR), median follow-up, and tumor, node, metastasis (TNM) stage, but the RN group had significantly higher age and American Society of Anesthesiologists (ASA) score.
Six months after surgery, eGFR was significantly higher in the PN than RN group. RN was associated with a significant threefold increased risk of new-onset CKD compared with PN, the investigators reported online ahead of print in the Scandinavian Journal of Urology.
After a median follow-up of 44 months, no patients in either group had a recurrence of RCC. The five-year overall survival was 100% and 65% in the PN and RN groups, respectively.
“These findings suggest that PN successfully preserves kidney function compared to RN, with good oncological outcome and survival,” the authors concluded.