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Kidney Week

Abstract: SA-PO200

Partial Nephrectomy Was Associated with Increased Risk of Long-Term CKD in Kidney Cancer Patients

Session Information

  • Onco-Nephrology: Clinical
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Rodrigues, Gilberto José, São Paulo State Cancer Institute, São Paulo, Brazil
  • Guglielmetti, Giuliano Betoni, São Paulo State Cancer Institute, São Paulo, Brazil
  • Torres, Veronica, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
  • Caires, Renato Antunes, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
  • Costalonga, Elerson, School of Medicine, University of Sao Paulo, São Paulo, São PAULO, Brazil
  • Cordeiro, Maurício, São Paulo Institute Cancer Center, São Paulo, Brazil
  • Nahas, William C., University of São Paulo Brazil, Sao Paulo, Brazil
Background

Few prospective studies assessed the risk of late kidney function impairment in kidney cancer (KC) patients (pts) after partial nephrectomy (PN) and most of them are based on measurement of serum creatinine level (SCr). The aim of this study is to perform a serial evaluation of radioisotopic glomerular filtration rate (rGFR) in patients (pts) with KC submitted to PN

Methods

Prospective evaluation of 97 outpts with KC admitted at the Sao Paulo State Cancer Institute between September 2012 and May 2018. All patients were submitted to PN and renal function was evaluated through 51Cr-EDTA rGFR at three different moments: before surgery (pre-rGFR), at three months after surgery (rGFR-3Mo) and twelve months after surgery (rGFR-12Mo). Acute kidney injury was defined as an increase ≥ 50% at the baseline serum SCr. GFR was expressed as ml/min/1.73m2. Chronic kidney disease (CKD) was defined as rGFR < 60

Results

Patients were 60 ± 12 years, 50.5% male. Hypertension was observed in 66% of pts and diabetes in 25.8%. CKD was observed in 16.5% of patients. KM had 3.30 (2.55-4.55) cm at largest diameter. Pre-operative exams were serum creatinine (SCr) 0.86 (0.75 – 1.06) mg/d and pre-rGFR 80.9 ± 27.3. Trans and immediate post-surgery period (next seven days) developed without serious complications: time of surgery was 120 (90-160) min, blood loss was 200 (100-500) ml, only three patients requiring blood transfusion. AKI was observed in 20.6% of pts, none of them required renal replacement therapy. rGFR-3Mo and rGFR-12Mo were reduced compared to pre-rGFR: 74.37 ± 23.2 (P<0.0001), and 73.23 ± 22.5 (P<0.0001), respectively. CKD prevalence increased at three (23.7%, P= 0.04) and twelve months (21.6%, P= 0.03) compared to the pre-surgery period

Conclusion

Uncomplicated PN was related with reduced rGFR and higher risk of CKD development at the long term in this group of KC patients