Dual CKD Risk Factors Prompt Greater Nephron-Sparing Surgery Use

Nephron-sparing surgery (NSS) for renal cell carcinoma (RCC) is used more frequently among patients with both diabetes and hypertension than those with one or neither of these conditions, according to researchers.

Christopher P. Filson, MD, MS, and colleagues at the University of Michigan in Ann Arbor identified 835 RCC patients treated with either radical nephrectomy (78%) or NSS (22%). Of these patients, 60% had pre-existing diabetes or hypertension or both. Compared with patients who neither of these risk factors for chronic kidney disease (CKD), those suffering from both conditions were twice as likely to receive NSS, investigators reported online ahead of print in Urologic Oncology. Patients with hypertension alone or diabetes alone were no more likely to receive NSS than patients with neither condition.

“The more frequent utilization of NSS among patients with both diabetes and hypertension suggests growing recognition by urologists of the importance of these risk factors for future development of CKD among patients facing surgical therapy for RCC,” Dr. Filson and his colleagues concluded. “The concurrent observation that patients with only one of the CKD risk factors did not receive increased utilization of NSS highlights an immediate opportunity to improve the surgical treatment of patients with RCC.”

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