The 1-year decline in estimated glomerular filtration rate (eGFR) after radical nephrectomy in patients with renal masses and matched living kidney donors is the same

Authors


Abstract

Objectives

  • To determine short-term differences in renal function evolution between patients with renal cell carcinoma (RCC) submitted to radical nephrectomy (RN) and living kidney donors matched for age and gender.
  • To assess the role of co-morbidity as a risk factor for developing an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2.

Patients and Methods

  • In this retrospective study patients undergoing Radical Nefrectomy (RN) between January 2000 and February 2011 for suspicion of localised RCC were matched by age and gender to living kidney donors.
  • Renal function was compared between the groups using the Modification in Diet and Renal Disease (MDRD) equation at 1 year after RN.
  • Charlson co-morbidity score, incidence of hypertension, diabetes and cardiovascular disease were compared and assessed as predictors for developing an eGFR of <60 mL/min/1.73 m2.

Results

  • In all, 196 patients were included, 98 in each group.
  • The mean age was respectively 60.6 (RCC group) and 59.1 years (donors).
  • The 1-year postoperative mean eGFR (available in 89 patients with RCC and 87 donors) was similar, at a mean (sd) of 56.7 (16.4) mL/min/1.73 m2 in patients with RCC and 56.2 (9.8) mL/min/1.73 m2 in donors (P = 0.83).
  • In patients with RCC the incidence and severity of co-morbidities was significantly higher.
  • A preoperative eGFR of 60–89 mL/min/1.73 m2 was the only independent risk factor for developing a postoperative eGFR of <60 mL/min/1.73 m2 (odds ratio 4.4, confidence interval 2.1–9.5, P < 0.001, 95% confidence interval).

Conclusions

  • In our cohorts with advanced age the 1-year follow-up eGFR was similar in both groups.
  • Despite increased co-morbidity in the RCC group there was no increased decline in renal function.
  • Only reduced preoperative eGFR could be identified as risk factor for developing a postoperative eGFR of <60 mL/min/1.73 m2.

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