Long-Term Renal Function Recovery following Radical Nephrectomy for Kidney Cancer: Results from a Multicenter Confirmatory Study

J Urol. 2018 Apr;199(4):921-926. doi: 10.1016/j.juro.2017.10.027. Epub 2017 Oct 21.

Abstract

Purpose: We sought to confirm the findings from a previous single institution study of 572 patients from Memorial Sloan Kettering Cancer Center in which we found that 49% of patients recovered to the preoperative estimated glomerular filtration rate within 2 years following radical nephrectomy for renal cell carcinoma.

Materials and methods: A multicenter retrospective study was performed in 1,928 patients using data contributed from 3 independent centers. The outcome of interest was postoperative recovery to the preoperative estimated glomerular filtration rate. Data were analyzed using cumulative incidence and competing risks regression with death from any cause treated as a competing event.

Results: This study demonstrated that 45% of patients had recovered to the preoperative estimated glomerular filtration rate by 2 years following radical nephrectomy. Furthermore, this study confirmed that recovery of renal function differed according to preoperative renal function such that patients with a lower preoperative estimated glomerular filtration rate had an increased chance of recovery. This study also suggested that larger tumor size and female gender were significantly associated with an increased chance of renal function recovery.

Conclusions: In this multicenter retrospective study we confirmed that in the long term a large proportion of patients recover to preoperative renal function following radical nephrectomy for kidney tumors. Recovery is more likely among those with a lower preoperative estimated glomerular filtration rate.

Keywords: carcinoma; creatinine; kidney; kidney function tests; nephrectomy; renal cell.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate*
  • Humans
  • Kidney / physiopathology*
  • Kidney / surgery
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / physiopathology
  • Kidney Neoplasms / surgery*
  • Male
  • Middle Aged
  • Nephrectomy*
  • Postoperative Period
  • Preoperative Period
  • Recovery of Function*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Time Factors
  • Treatment Outcome
  • Tumor Burden