Incidence and risk factors of chronic kidney disease in korean patients with t1a renal cell carcinoma before and after radical or partial nephrectomy

• Published in: Japanese journal of clinical oncology 2013-12, Vol.43 (12), p.1243-1248
• Main Authors: Kim, Sung Han, Lee, Sang Eun, Hong, Sung Kyu, Jeong, Chang Wook, Park, Yong Hyun, Kim, Yong-June, Kang, Seok Ho, Hong, Sung-Hoo, Choi, Won Suk, Byun, Seok-Soo
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Asian Continental Ancestry Group - statistics & numerical data; Biomarkers - blood; Calcium - blood; Carcinoma, Renal Cell - blood; Carcinoma, Renal Cell - diagnosis; Carcinoma, Renal Cell - surgery; Creatinine - blood; Female; Glomerular Filtration Rate; Humans; Hypertension - complications; Incidence; Kidney Function Tests; Kidney Neoplasms - blood; Kidney Neoplasms - diagnosis; Kidney Neoplasms - surgery; Laparoscopy; Male; Middle Aged; Multivariate Analysis; Nephrectomy - adverse effects; Nephrectomy - methods; Odds Ratio; Predictive Value of Tests; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - etiology; Renal Insufficiency, Chronic - physiopathology; Renal Insufficiency, Chronic - prevention & control; Republic of Korea - epidemiology; Retrospective Studies; Risk Factors; Serum Albumin - metabolism; Sex Factors
• ISSN: 0368-2811; 1465-3621
• DOI: 10.1093/jjco/hyt149

The aim of the study was to investigate the incidence of chronic kidney disease in patients with T1a renal cell carcinoma both before and after partial or radical nephrectomy, and to assess risk factors for chronic kidney disease. From January 2001 to December 2011, 1928 patients with a single renal mass ≤4 cm undergoing partial nephrectomy or radical nephrectomy with the existence of a normal contralateral kidney were retrospectively reviewed for the evaluation of preoperative chronic kidney disease, and reviewed only 1676 patients for the postoperative chronic kidney disease. The estimated glomerular filtration rates were used to define chronic kidney disease 65 years of age. Between the non-chronic kidney disease and chronic kidney disease patients, male gender (odds ratio 3.55 vs. 3.78, respectively) and diagnostic age (odds ratio 1.04 vs. 1.05) were significantly distinctive common risk factors for chronic kidney disease both before and after surgery (P < 0.002). In addition, hypertension (odds ratio 0.46), serum albumin (odds ratio 0.23) and calcium (odds ratio 2.06) were significant as preoperative risk factors (P < 0.015), and preoperative serum creatinine (odds ratio 1.90) and surgical type (partial nephrectomy or radical nephrectomy; odds ratio 11.89) were significant as postoperative risk factors (P < 0.030). Old, male hypertensive patients with a small renal mass would be better candidates for partial nephrectomy to prevent postoperative chronic kidney disease.