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

• Published in: BJU international Vol. 113; no. 5b; pp. E49 - E55
• Main Authors: Hew, Miki N., Opondo, Dedan, Cordeiro, Ernesto R., Donselaar‐van der Pant, Karlijn A.M.I., Bemelman, Frederike J., Idu, Mirza M., Rosette, Jean J.M.C.H., Laguna, M. Pilar
• Format: Journal Article
• Language: English
• Published: England 01.05.2014
• Subjects: Carcinoma, Renal Cell - physiopathology; Carcinoma, Renal Cell - surgery; co‐morbidity; Donor Selection; Female; Glomerular Filtration Rate; Humans; Kidney Neoplasms - physiopathology; Kidney Neoplasms - surgery; living donor; Living Donors; Male; Middle Aged; nephrectomy; Nephrectomy - methods; renal cell carcinoma; renal function; Retrospective Studies; Risk Factors; Time Factors; living donor; renal function; renal cell carcinoma; nephrectomy; co-morbidity
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/bju.12345

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.