End-Stage Renal Disease (ESRD) Risk Lower with Partial Nephrectomy

Researchers find a greater than 50% reduction in end-stage renal disease risk.
Researchers find a greater than 50% reduction in end-stage renal disease risk.

Partial nephrectomy is associated with a lower risk of end-stage renal disease (ESRD) requiring renal replacement therapy compared with radical nephrectomy, according to a new study.

Stanley A. Yap, MD, of the University of California San Diego, and colleagues studied 11,937 patients who underwent surgery for pathologically confirmed RCC. Of these, 2,107 underwent partial nephrectomy (PN) and 9,830 underwent radical nephrectomy (RN). Separately, the researchers analyzed a “modern cohort” of patients who had surgery during the period 2003–2010.

The median follow-up was 57 months. In the study population overall, the type of surgery was not associated with the rate of ESRD, but in the modern cohort, PN was associated with a significant 53% decreased risk of ESRD in a propensity-score-matched analysis and a significant 56% decreased risk in a multivariable analysis, the researchers reported online ahead of print in BJU International.

PN also was associated with a significant 52% and 50% lower risk of new-onset chronic kidney disease (CKD), respectively, based on propensity-score-matching and multivariable analyses.

“Although it is well-known that RN is associated with more CKD than PN, we provide the first direct evidence that PN is associated with less ESRD requiring renal replacement therapy than RN in a modern cohort of patients with RCC,” the authors concluded.

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