Improper Patient Selection for NSS May Increase CKD Risk

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In a study, chronic kidney disease was nearly twice as likely to develop in patients who had post-operative complications following nephron-sparing surgery.
In a study, chronic kidney disease was nearly twice as likely to develop in patients who had post-operative complications following nephron-sparing surgery.

Improper patient selection could increase the risk of chronic kidney disease (CKD) among patients with normal preoperative renal function undergoing nephron-sparing surgery (NSS) for kidney cancer, according to a recent study.

In a study of 596 patients with normal pre-operative renal function treated with NSS for clinical T1abN0M0 renal masses, investigators in Italy found that 137 (23%) experienced post-operative complications. After a median follow-up of 53 months (range 26 to 91 months), CKD developed in 19% of patients who had post-operative complications compared with 11% among those who did not. On multivariable analysis, post-operative complications were significantly associated with a nearly 2-fold increased risk of CKD.   

“Our data outline how post-operative complications might have a detrimental impact on post-operative renal function in patients submitted to NSS,” investigators Eugenio Ventimiglia, MD, of the Università Vita-Salute San Raffaele and Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy, and colleagues reported in BJU International. “Improper patient selection, increasing the risk of post-operative complications, could limit the benefit in terms of renal function brought by NSS.” 

References

Ventimiglia E, Larcher A, Trevisani F, et al. Post-operative complications increase the risk of long-term chronic kidney disease after nephron sparing surgery in renal cancer patients with normal preoperative renal function. BJU Int. 2019; published online ahead of print.

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