Elevated CKD Risk May Remain Despite Partial Nephrectomy
Risk is not eliminated if patients have risk factors for CKD.
STOCKHOLM—Radical nephrectomy is a significant risk factor for the development of new-onset chronic kidney disease (CKD), but partial nephrectomy does not completely eliminate the risk if patients have CKD risk factors, according to study findings presented at the European Association of Urology 29th annual congress.
Prassannah Satasivam, MD, of Monash Health in Melbourne, Australia, and colleagues conducted an 8-year retrospective review of 488 surgeries for renal cell carcinoma (RCC): 332 radical nephrectomies (RN) and 156 partial nephrectomies (PN).
Patients undergoing RN had a significantly greater mean percentage reduction in estimated glomerular filtration rate (eGFR) at 6 months than those undergoing PN (26% vs. 7%).
In the RN group, new-onset CKD (eGFR below 60 mL/min/1.73 m2) developed in 33% of patients with no risk factors and 70% of patients older than 60 years, 67%, of those with hypertension, and 70% of those with diabetes mellitus.
In the PN group, new-onset CKD developed in 7% of patients without risk factors, 24% of patients older than 60 years, 30% of those with hypertension, and 42% of those with diabetes. In multivariate analysis, older age, diabetes mellitus, and preoperative renal impairment, but not hypertension, were associated with an increased risk of postoperative CKD.