SUO 2018: Three-year Renal Functional Outcomes of Patients Enrolled in the Intravenous Mannitol Versus Placebo During Partial Nephrectomy Randomized Controlled Trial

Phoenix, Arizona ( A previous prospective, randomized, double blind placebo controlled trial found that mannitol had no impact on renal function at 6 weeks and 6 months post operatively in patients with normal preoperative renal function undergoing partial nephrectomy. It had been hypothesized that mannitol may diminish reactive oxygen species that cause kidney damage. This abstract examined the 3 year long term renal functional outcomes of this previously presented study.

At Memorial Sloan Kettering Cancer Center, from 2012-2015, over 200 patients with a glomerular filtration rate > 45 undergoing partial nephrectomy were randomized to receive 12.5 grams of mannitol or placebo 30 minutes prior to clamping.

The median age was 57.8 years with the majority of patients male and white and had a median follow up of 3.8 years. At 3 years, no differences were demonstrated in GFR between patients in the mannitol and placebo arms. Additionally, across all time points (6 months, 1, 2, and 3 years) no statistically significant differences were seen in post-operative GFR.

This interesting study helps disprove previously believed urologic dogma and may continue to guide practice patterns. Multiple other studies have examined other factors which may influence on post-operative GFR including ischemia time, traditional partial nephrectomy versus enucleation, amongst others. Ultimately, confirming the mannitol data with longer term follow up, may alter urologic surgeons techniques to support practice of evidence based medicine.

Presented By: Nathan Wong, MD, Sloan Kettering Cancer Center

Written by: David B. Cahn, DO, MBS, Fox Chase Cancer Center, Philadelphia, PA, @dbcahn, at the 19th Annual Meeting of the Society of Urologic Oncology (SUO), November
28-30, 2018 – Phoenix, Arizona