San Diego, California (UroToday.com): A podium presentation was presented in today’s Kidney Cancer: Localized: Surgical Therapy II session at the AUA 2016 evaluating the relationship of post-operative chronic kidney disease subtype status and outcomes in patients undergoing renal surgery. Dr Miki Haifler opened his talk stating that all patients undergoing radical or partial nephrectomy are at risk of developing new or progressive chronic kidney disease.
Recent studies suggested that chronic kidney disease of surgical origin (CKD-S) had less impact on survival compared with CKD of combined medical and surgical origin (CKD-M/S). The authors sought to externally validate the CKD-S/M model in a large cohort of patients undergoing kidney surgery. Data was collected from an IRB approved and prospectively maintained kidney cancer database. The study included all patients who were diagnosed with renal cell carcinoma between 1994 and 2014. eGFR was calculated using the CKD-EPI at 2 time points: Baseline eGFR (preoperative) and Postoperative eGFR (30 days postoperative).
The patients were divided into 3 groups according to these eGFR values:
No CKD - baseline and postoperative GFR both >60 ml/min/1.73 m2
CKD-S - postoperative GFR <60 ml/min/1.73 m2 and baseline GFR >60 ml/min/1.73 m2
CKD-M/S - baseline and postoperative GFR both <60 ml/min/1.73 m2
The study endpoints were overall and non-cancer related survival.
947 patients were included in the study. No CKD, new onset CKD-S and persistent CKD-M/S groups included 525 (55.4%), 267 (28.2%) and 155 (16.4%) patients respectively. CKD-M/S had a lower new baseline GFR compared with CKD-S and no CKD (40 vs. 49 vs. 83, p<0.0001).
The median follow-up was 40.1 m (IQR 18.6-69.9). CKD-M/S and CKD-S groups experienced similar overall survival for the first 5 years after surgery, but CKD-M/S survival declined thereafter. The CKD-s and CKD-M/S had similar non cancer related survival even beyond the first 5 years after the surgery.
The authors conclude that their result mostly agree with previously published data on the subject. Initial survival outcomes of patients after renal surgery depend on the post-operative renal function only.
Presented By: Miki Haifler, MD
Written By: Miki Haifler MD. Fox Chase Cancer Center, Philadelphia, PA. at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA