SAN DIEGO—Older hypertensive men with small kidney tumors and normal contralateral kidneys should have their preoperative renal function evaluated carefully to prevent postoperative chronic kidney disease (CKD), South Korean researchers reported at the American Urological Association 2013 annual meeting.
In addition, the researchers concluded that partial rather than radical nephrectomy should first be considered first to lower the risk of postoperative CKD.
Sung Han Kim, MD, and colleagues at Seoul National University retrospectively studied 1,928 patients with single stage T1a renal cell carcinoma tumors who were undergoing partial or radical nephrectomy and had normal contralateral kidney function from January 2001 to December 2011. CKD was identified preoperatively in 10% of patients and postoperatively in 16.1% of patients.
Of 447 patients older than 65 years, 87 had CKD at baseline whereas 102 developed CKD after surgery. Multivariate analyses showed that male gender and diagnostic age were significant CKD risk factors before and after surgery.
Hypertension, serum albumin, and calcium were significant risk factors for preoperative CKD, whereas serum creatinine and surgical type (partial or radical nephrectomy) were risk factors for postoperative CKD. Compared with partial nephrectomy, radical nephrectomy was associated with an 8.2 times increased risk of postoperative CKD.