Patients undergoing laparoscopic cryoablation (LCA) for renal masses experience a minimal decline in renal function at mid-term follow-up, and this decline is similar for patients with and without chronic renal insufficiency (CRI), researchers concluded.
In a study of patients who had the procedure, researchers found that although serum creatinine (sCr) values and estimated glomerular filtration rate (eGFR) were consistently better in patients with normal renal function (NRF) at baseline, “the amount and percentage of impairment after LCA were comparable to those observed in CRI patients,” according to a report in the Journal of Endourology (2011;25:1287-1291). “Therefore, LCA may represent an excellent option for the treatment of small renal masses in patients with preexisting CRI.”
Matvey Tsivian, MD, and collaborators at Duke University Medical Center in Durham, N.C., analyzed data from 67 patients undergoing LCA for renal masses. Of these, 22 (33%) had CRI at baseline and 45 had NRF. CRI was defined as an eGFR below 60 mL/min/1.73 m2. RCC was diagnosed in 77% and 71% of the CRI and NRF patients, respectively. The researchers followed patients for up to two years.
Although serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) were significantly different between the CRI and NRF patients over the two-year follow-up, the changes in both values were similar for both groups.
From baseline to two years, the median change in serum creatinine value was 0.1 mg/dL in both the CRI and NRF groups. During that period, the eGFR (in mL/min/1.73 m2) declined by a median of 4.2 in the CRI group and 8.7 in the NFR group. No patient progressed to end-stage renal disease requiring dialysis.