Deterioration in the renal function and risk of microalbuminuria after radical, simple and donor nephrectomy: A long-term outcome

Verma, Shashi; Yadav, Sher Singh; Tomar, Vinay; Vyas, Nitya; Agarwal, Neeraj; Sharma, Umesh

doi:10.4103/0974-7796.164854

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…12,13,14 However, in developed countries where imaging modality is frequently performed, incidental RCC burden is more and is up to 50% of cases. 15 While our study reported 40% incidental cases close to those presented in western literature. Incidental cases are uncommon in developing countries partly because of the low availability of imaging modalities and late presentation to hospitals with severe symptoms of a particular disease.…”

Section: Discussionsupporting

confidence: 76%

Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Roman

Habib²,

Alam³

2022

PAFMJ

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Objective: to identify the demographic, laboratory, radiological and histological features of RCC patients presenting to a tertiary care hospital in Islamabad. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Atomic Energy Commission General Hospital, Islamabad Pakistan, from Jan 2014 to Aug 2021. Methodology: All the patients who underwent radical nephrectomy for histologically confirmed RCC at PAEC General Hospital Islamabad were included in the study. Demographic variables, ultrasound features, laboratory measures, histological types and Fuhrman grading were noted. Results: A total of 65 consecutive patients were included, which included 38(58.5%) males. The mean age of the patients was 52.6±8.6 years. The most common symptom was flank pain (42.2%). The diagnosis was made incidentally in 26 patients. The most common ultrasound feature was capsule involvement (23, 35.3%), and most cases were Fuhrman Grade-II (22, 48.9%). On histology, clear cell carcinoma was the most common RCC (40, 61.5%). Post-operative early RFT deterioration was noted in 32(49.2%) patients. This was significantly associated with greater tumour size, Fuhrman Grade-III/IV, renal vein thrombosis, gerota fascia, and ureteric involvement. There was no mortality in our study during the admission days until discharge. Conclusion: Renal cell carcinoma was more common among males and at a later stage of life (5th decade). The most common type was clear cell carcinoma. Post-operative early RFT deterioration was noted in 49.2% of patients. It was associated with greater tumour size, Fuhrman Grade III and IV, renal vein thrombosis, gerota fascia, and ureteric involvement.

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Section: Discussionsupporting

confidence: 76%

Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Roman

Habib²,

Alam³

2022

PAFMJ

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“…Consistent with our study, they reported that patients undergoing LRN were older, had a higher frequency of comorbid diseases, and experienced a higher frequency and severity of chronic kidney disease postoperatively. The best results were reported in the LDN group [17]. In another study evaluating the effect of all 3 laparoscopic nephrectomy techniques on health-related quality of life, Wiesenthal et al reported that patients undergoing LRN were significantly older than the other 2 groups.…”

Section: Discussionmentioning

confidence: 99%

Comparing the complications of laparoscopically performed simple, radical and donor nephrectomy

Olcucuoglu¹

2020

Turk J Med Sci

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Bacground/aim The aim of this study was to compare the complications of laparoscopic simple, radical and donor nephrectomies performed in a single center. Materials and methods The study was conducted on 392 patients who underwent laparoscopic nephrectomy in University of Health Sciences, Ankara Türkiye Yüksek İhtisas Training and Research Hospital between January 1, 2008 and January 30, 2019. Clinical and laboratory parameters were recorded. Postoperative complications were recorded and graded as per Clavien-Dindo classification (CDC). All analyses were performed on SPSS v21.0 (IBM Corp., Armonk, NY, USA). Results The mean age of the patients was 49.13 ± 15.45 years. The frequency of comorbidities and ASA scores were significantly higher in the laparoscopic radical nephrectomy (LRN) group than in the other groups (P < 0.001). Amount of bleeding was significantly lower in the laparoscopic donor nephrectomy (LDN) group compared to the other groups (P < 0.001). Classification of complications according to CDC showed that complications occurred in 17.01% (n = 25) of the LRN group, 7.02% (n = 12) of the laparoscopic simple nephrectomy (LSN) group, and 2.70% (n = 2) of the LDN group. Length of stay in hospital was significantly higher in the LRN group than in the LSN group (P < 0.001). Conclusion In this study, the frequency of complications in LRN procedures was found to be higher than the LSN and LDN procedures. Patients with LRN may have more adverse health conditions before the operation. Considering the results of this study, variables such as patient and hospital characteristics, surgeon experience and skills should be evaluated in future studies. In addition, it is important to determine the frequency of complications using a standardized classification in order to enable correct interpretation of results.

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“…After two years of follow-up, the difference in GFR was found to be significant between RN and SN, or RN and DN. At postoperative 6th years, while 41.6% of patients in RN group and 8.6% of patients in SN group developed stage 3 CKD, only 3 patients in DN group developed stage 1 CKD (Verma et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Comparison of long-term kidney functions after radical nephrectomy and simple nephrectomy

Olcucuoglu

Tonyalı

Taştemur

et al. 2019

PeerJ

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Objective To determine if there is a difference in proceeding to CKD between patients who had undergone radical nephrectomy (RN) and simple nephrectomy (SN) for different indications by comparing the short- and long-term renal function. Materials and Methods We retrospectively analyzed the records of all patients who underwent nephrectomy (either for malign or benign indications) in our clinic between January 2007 and September 2017. The patients were divided into 2 groups according the type of surgery: 1) Radical nephrectomy Group, 2) Simple Nephrectomy Group. Renal function was evaluated with Glomerular Filtration Rate (GFR) calculated using the MDRD formula. Results A total of 276 patients were included in the study. There were 202 patients in RN Group and 74 patients in SN Group. The mean age of the patients in RN Group and SN Group were age 59,2 ± 11,5 and 49,9 ± 15,1 years, respectively (p = 0.001). GFR levels of patients in RN Group versus SN Group were as follows: Preoperative period: 84.9 vs. 81 mL/min/1.73 m2; postoperative 1st day: 60.5 vs. 84.4 mL/min/1.73 m2, postoperative 1st month 58.9 vs. 76 mL/min/1.73 m2, postoperative 1st year: 59.5 vs. 74.1 mL/min/1.73 m2; at last control 60.3 and 76.1 mL/min/1.73 m2. While preoperative GFR was found to be similar in two groups (p = 0.26), postoperative GFR values were found to be significantly lower in Group RN (p < 0.001). In comparison of the decrease in GFR in two groups at last follow-up, significantly higher decrease was observed in RN Group, 29% vs. 6%, (p < 0.05). Conclusion The decrease in GFR exists more common and intensive after RN compared to SN. In long-term, compensation mechanisms that develop after sudden nephron loss like radical nephrectomy deteriorates kidney function more than gradual nephron loss as in benign etiologies which indicates simple nephrectomy.

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Deterioration in the renal function and risk of microalbuminuria after radical, simple and donor nephrectomy: A long-term outcome

Cited by 7 publications

References 27 publications

Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Radical Nephrectomy for Renal Cell Carcinoma in a Tertiary Care Hospital in Islamabad

Comparing the complications of laparoscopically performed simple, radical and donor nephrectomy

Comparison of long-term kidney functions after radical nephrectomy and simple nephrectomy

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