TY - JOUR
T1 - Chronic kidney disease after nephrectomy in patients with small renal masses
T2 - A retrospective observational analysis
AU - Sun, Maxine
AU - Bianchi, Marco
AU - Hansen, Jens
AU - Trinh, Quoc Dien
AU - Abdollah, Firas
AU - Tian, Zhe
AU - Sammon, Jesse
AU - Shariat, Shahrokh F.
AU - Graefen, Markus
AU - Montorsi, Francesco
AU - Perrotte, Paul
AU - Karakiewicz, Pierre I.
PY - 2012/10
Y1 - 2012/10
N2 - Context: Chronic kidney disease (CKD) is a worldwide health threat associated with increased cardiovascular disease and mortality. Objective: To examine postoperative CKD in patients with small renal masses (SRMs) treated with partial nephrectomy (PN) or radical nephrectomy (RN). Design, setting, and participants: A US National Cancer Institute Surveillance Epidemiology and End Results (SEER)-Medicare-linked retrospective cohort of 4633 T1aN0M0 renal cell carcinoma (RCC) patients who underwent PN or RN. Outcome measurements and statistical analysis: The primary outcome of interest was the onset of CKD stage ≥3. Secondary end points comprised acute renal failure (ARF), chronic renal insufficiency (CRI), anemia in CKD, and end-stage renal disease (ESRD). Kaplan-Meier and Cox regression analyses were performed. Results and limitations: Postpropensity matching resulted in 840 RN and PN patients. In multivariable analyses, RN patients were 1.9-, 1.4-, 1.8-, and 1.8-fold more likely to have an occurrence of CKD, ARF, CRI, and anemia in CKD, respectively (all p ≤ 0.004). The risk of ESRD between treatment groups failed to achieve statistical significance (p = 0.06). Conclusions: PN is associated with more favorable postoperative renal function outcomes relative to RN in the setting of SRMs.
AB - Context: Chronic kidney disease (CKD) is a worldwide health threat associated with increased cardiovascular disease and mortality. Objective: To examine postoperative CKD in patients with small renal masses (SRMs) treated with partial nephrectomy (PN) or radical nephrectomy (RN). Design, setting, and participants: A US National Cancer Institute Surveillance Epidemiology and End Results (SEER)-Medicare-linked retrospective cohort of 4633 T1aN0M0 renal cell carcinoma (RCC) patients who underwent PN or RN. Outcome measurements and statistical analysis: The primary outcome of interest was the onset of CKD stage ≥3. Secondary end points comprised acute renal failure (ARF), chronic renal insufficiency (CRI), anemia in CKD, and end-stage renal disease (ESRD). Kaplan-Meier and Cox regression analyses were performed. Results and limitations: Postpropensity matching resulted in 840 RN and PN patients. In multivariable analyses, RN patients were 1.9-, 1.4-, 1.8-, and 1.8-fold more likely to have an occurrence of CKD, ARF, CRI, and anemia in CKD, respectively (all p ≤ 0.004). The risk of ESRD between treatment groups failed to achieve statistical significance (p = 0.06). Conclusions: PN is associated with more favorable postoperative renal function outcomes relative to RN in the setting of SRMs.
KW - Chronic kidney disease
KW - Nephrectomy
KW - Nephron-sparing
KW - Renal function
KW - Small renal masses
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U2 - 10.1016/j.eururo.2012.03.051
DO - 10.1016/j.eururo.2012.03.051
M3 - Article
C2 - 22483407
AN - SCOPUS:84865678355
VL - 62
SP - 696
EP - 703
JO - European Urology
JF - European Urology
SN - 0302-2838
IS - 4
ER -