Journal Article Page
European UrologyVolume 62, issue 4, pages e69-e82, October 2012
Chronic Kidney Disease After Nephrectomy in Patients with Small Renal Masses: A Retrospective Observational Analysis
Accepted 23 March 2012, Published online 31 March 2012, pages 696 - 703
Chronic kidney disease (CKD) is a worldwide health threat associated with increased cardiovascular disease and mortality.
To examine postoperative CKD in patients with small renal masses (SRMs) treated with partial nephrectomy (PN) or radical nephrectomy (RN).
Design, setting, and participants
A US National Cancer Institute Surveillance Epidemiology and End Results (SEER)–Medicare-linked retrospective cohort of 4633 T1aN0M0 renal cell carcinoma (RCC) patients who underwent PN or RN.
Outcome measurements and statistical analysis
The primary outcome of interest was the onset of CKD stage ≥3. Secondary end points comprised acute renal failure (ARF), chronic renal insufficiency (CRI), anemia in CKD, and end-stage renal disease (ESRD). Kaplan-Meier and Cox regression analyses were performed.
Results and limitations
Postpropensity matching resulted in 840 RN and PN patients. In multivariable analyses, RN patients were 1.9-, 1.4-, 1.8-, and 1.8-fold more likely to have an occurrence of CKD, ARF, CRI, and anemia in CKD, respectively (all p≤ 0.004). The risk of ESRD between treatment groups failed to achieve statistical significance (p = 0.06).
PN is associated with more favorable postoperative renal function outcomes relative to RN in the setting of SRMs.
Recommend this article
Currently this article has a rating of 1. Please log in to recommend it.