J Clin Nephrol Kidney Dis | Volume 5, Issue 1 | Research Article | Open Access

CKD Outcomes after Nephron Sparing Surgery with Non-Ischemia vs. Radical Nephrectomy for Renal Cell Carcinoma

Katsunori Yoshida1*, Tatsuo Yoneda2, Masaomi Kuwada2, Syunta Hori2 and Kiyohide Fujimoto2

1Department of Urology, Saiseikai Chuwa Hospital, Japan 2Department of Urology, Nara Medical University, Japan

*Correspondance to: Katsunori Yoshida 

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Abstract

Purpose: Recently, Partial Nephrectomy (PN) is not inferior to Radical Nephrectomy (RN) concern about cancer specific survival in small renal cell. PN is now standard for clinical stage T1 Renal Cell Carcinoma (RCC). We evaluate whether no-ischemic PN provided keeping renal functional outcomes compared with RN. Material and Methods: From 1993 to 2009, 226 patients with RCC underwent extirpative surgery, PN (75) or RN (151). PN was treated with non-ischemic procedure. The inclusion criteria were as follows: Patients have been inspected regularly more than three years, and end-point was to ten years. Renal function (eGFR) was measured at pre-operation, 1-month, 1-year, 3-years, 5-years and 10-years after operation. Results: Preoperative e-GFR of PN and RN are similar (74.9 ± 14.8 to 74.4 ± 24.8 ml/min/1.73 m2). However, e-GFR of RN is lower than that of PN (1 month 48.8/71.1, 1 year 49.7/68.0, 3 years 50.5/69.1, 5 years 51.5/67.9, 10 years 50.0/66.9 ml/min/1.73 m2). Preoperative CKD G1+G2 rate of PN and RN were similar (23% + 49% and 22% + 52%). But, the rate of RN at 1 month after operation was deteriorated comparison with PN through all periods until ten years. CKD G4+G5 rate of RN is increased at ten years later (14%) comparison with preoperative rate (3%). While, that of PN is not changed between preoperative rate (3%) and ten years later (4%). Conclusion: Renal functional of PN is superior to RN for clinical stage T1. PN is complete surgical excision and should be strongly considered for prevention of postoperative CKD. PN should be recommended in most patients with small RCC.

Keywords:

CKD outcomes; Partial nephrectomy; Radical nephrectomy; Renal cell carcinoma

Citation:

Yoshida K, Yoneda T, Kuwada M, Hori S, Fujimoto K. CKD Outcomes after Nephron Sparing Surgery with NonIschemia vs. Radical Nephrectomy for Renal Cell Carcinoma. J Clin Nephrol Kidney Dis. 2020;5(1):1027..

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