Renal function after nephron-sparing surgery for renal tumors

Abstract

Nephron sparing surgery (NSS) is a technique more frequently utilized in the case of surgical treatment of kidney tumor. The aim of the study is to assess renal function in patients treated with NSS for renal tumors. Twenty patients, after NSS performed for renal tumor, were included in the study. In each patient dynamic renal scintigraphy was performed before surgical treatment (test No. 1) and after a mean interval of 12 months after surgical procedure (test No. 2). In each test renographic curves were evaluated. Creatinine levels and GFR rates were also assessed. Mean GFR was 84 ml/min/1.73 m2 before surgery, and 79 ml/min/1.73 m2 after surgical procedure. Mean change of GFR value after the surgical procedure was -5.1 (p >0.058). On renography significant deterioration of renal function was observed in the operated kidneys of 4 patients (20%) after NSS, insignificant deterioration - in four patients (20%) and improvement of renal function of operated kidney was found in one patient. In 12 patients (60%) no change was observed. The relative percentage GFR-share of operated kidney decreased by the average value of 3.8% (p >0.005). Multifactorial analysis did not identify significant effect of potential risk factors on the function of the kidney subjected to NSS. Preliminary results of this study confirm that deterioration of renal function after NSS is a rare event.

Synchronous bilateral wilms tumor: Five-year single-center experience with assessment of quality of life

“…found in their study on twenty patients with NSS for renal tumor that only four patients had significant deterioration in renal function after comparing the mean GFR. [23] Costabel et al . in their study on 45 patients with NSS for solitary kidney tumor over 10 years found significantly lower calculated GFR after surgery with loss of renal mass and male gender.…”

“…All the patients received adjuvant chemotherapy for 0–34 weeks with vincristine, dactinomycin, and/or doxorubicin as when deemed necessary and other drugs after consultation with medical oncology department. Renal function status was assessed with Tc-99m DTPA scan prior to surgery and 3 months after bilateral NSS and at follow-up yearly, and the total glomerular filtration rate (GFR) was noted[23] [Table 2]. In the interval between the two surgeries, renal function assessment was made with serum creatinine level.…”