Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study

Abstract

SummaryBackground-Chronic kidney disease is a graded and independent risk factor for substantial comorbidity and death. We aimed to examine new onset of chronic kidney disease in patients with small, renal cortical tumours undergoing radical or partial nephrectomy.

Histopathologic Analysis of Peritumoral Pseudocapsule and Surgical Margin Status after Tumor Enucleation for Renal Cell Carcinoma

“…Nevertheless, whether or not to excise a rim of healthy parenchyma, theoretically necessary to avoid the risk of a positive SM and local recurrence, is a matter of great controversy, and recent reports concluded that the width of the resection margins does not correlate with disease progression and that if the tumor is completely excised, the margin size is irrelevant, thus providing an intriguing insight into the possibility of bluntly excising the tumor, such as a TE [13,14]. Moreover, from a functional point of view, a narrower excision margin in RCC tumors would lead to additional parenchymal tissue preservation, and a recent report by Huang et al showed that the new onset of GFR of <60 ml/min and of <45 ml/min per 1.73 m 2 in patients with small RCC tumors can occur also after standard partial nephrectomy in 20% and 5% of cases at 3-yr follow-up, respectively [27].…”

Active Surveillance for Renal Cortical Neoplasms

“…However, the importance of nephron-sparing surgery focuses not only on avoiding chronic renal insufficiency, but also to decrease the incidence of cardiovascular events and death. 8,9,10 Therefore, in patients with a renal mass ≤ 4cm (cT1a), partial nephrectomy is the new gold standard. It has even been suggested that tumors <7cm (cT1b) should be managed with parital nephrectomy when surgically feasible.…”

The Emergence of Surgeon-Controlled Robotic Surgery in Urologic Oncology

“…And third, it has also been found that a RN puts patients at an increased risk for chronic kidney disease [35]. Huang and colleagues did a retrospective cohort study of 662 patients undergoing elective partial or radical nephrectomy for a solitary, renal cortical tumor less than 4 cm [36]. Upon further examination, they noted that 171 (26%) of these patients had pre-existing chronic kidney disease prior to surgery [36].…”

“…Huang and colleagues did a retrospective cohort study of 662 patients undergoing elective partial or radical nephrectomy for a solitary, renal cortical tumor less than 4 cm [36]. Upon further examination, they noted that 171 (26%) of these patients had pre-existing chronic kidney disease prior to surgery [36]. By following these 171 patients for 3 years, Huang et al discovered that patients who underwent a RN had a 65% chance of developing chronic kidney disease as opposed to a 20% chance with a PN [36].…”

“…Upon further examination, they noted that 171 (26%) of these patients had pre-existing chronic kidney disease prior to surgery [36]. By following these 171 patients for 3 years, Huang et al discovered that patients who underwent a RN had a 65% chance of developing chronic kidney disease as opposed to a 20% chance with a PN [36]. In other words, the risk of developing chronic kidney disease after having a RN is three times greater than the risk associated with having a partial nephrectomy.…”