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BMC Nephrology

, 15:181

Clinical Research


BackgroundThis study aimed to compare the changes in kidney function and the association of tumor size and renal outcomes between patients with renal cell carcinoma RCC who underwent radical nephrectomy RN and those who underwent partial nephrectomy PN.

MethodsA retrospective cohort study was conducted for 557 patients with an RCC of ≤7 cm in diameter and normal contralateral kidney function who underwent PN or RN. PN was performed for 218 39% patients. Renal outcomes included the incidence of acute kidney injury AKI, new-onset chronic kidney disease CKD, and a ≥25% decline in eGFR 1 year after surgery.

ResultsSerial changes in eGFR were compared during the 3 years of follow-up. Postoperative eGFR was significantly lower in patients undergoing RN than in those undergoing PN. The incidence of AKI and new-onset CKD was significantly higher in patients after RN 70.1% vs. 24.3%, respectively; P <0.001 than after PN 55.7% vs. 6.2%, respectively; P <0.001. According to the multivariable logistic regression analysis, RN was an independent risk factor for a ≥25% decline in kidney function after 1 year regardless of the tumor size, even after adjusting for various covariates.

ConclusionsCompared to PN, RN for even a moderate sized RCC leads to an increased incidence of AKI and new-onset CKD, and is a significant risk factor for kidney function decline. Therefore, PN should be considered as the choice of surgical treatment for RCCs that are ≤7 cm in diameter in order to preserve renal function postoperatively.

KeywordsKidney function Nephrectomy Renal cell carcinoma AbbreviationsRCCRenal cell carcinoma

PNPartial nephrectomy

RNRadical nephrectomy

CKDChronic kidney disease

eGFREstimated glomerular filtration rate

SCrSerum creatinine

AKIAcute kidney injury

ANOVAAnalysis of variance.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2369-15-181 contains supplementary material, which is available to authorized users.

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Autor: Chang Seong Kim - Eun Hui Bae - Seong Kwon Ma - Sun-Seog Kweon - Soo Wan Kim


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