San Diego, CA USA (UroToday.com) Partial nephrectomy is the treatment of choice in patients with renal masses for the sake of preserving renal function. Chronic kidney disease (CKD), whether it is medical or surgical, is associated with significant morbidity and healthcare expenditures.
The leading causes of medical renal disease are hypertension (HTN) and diabetes mellitus (DM); however, it is unclear whether patients undergoing partial nephrectomy with either of these comorbidities suffer from greater surgical CKD.
The authors investigated this relationship in patients with clinical stage T1 renal masses with normal baseline kidney function treated with robotic partial nephrectomy from a multi-institutional kidney cancer database. Patients with HTN, DM, or both were grouped, while patients with none were in a separate group.
324 patients with a baseline estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m2 were included in the analysis. Interestingly, although patients in the HTN/DM/both group were significantly older, had a significantly higher BMI, and trended to having a lower pre-operative eGFR, there was no difference in the rate of progression of CKD following surgery. Post-operative eGFR at 6 months did not differ significantly between the two groups. In patients with eGFR ≥ 90 mL/min/1.73m2, there was no difference in the proportion of patients who upgraded to CKD stage two following the surgery.
The authors concluded that the presence of HTN and DM are not independent predictors of worsening renal function outcomes following robotic partial nephrectomy.
Presented By: Balaji Reddy, MD
Written By: Rahul Dutta, BS; Urology Fellow, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA