Progression to chronic kidney disease in patients undergoing nephrectomy for small renal masses: a price to pay for a therapeutic success?

Progression to chronic kidney disease in patients undergoing nephrectomy for small renal masses: a price to pay for a therapeutic success? Postgrad Med. 2018 Aug 14;: Authors: Charytoniuk T, Małyszko M, Bączek J, Fiedorczyk P, Siedlaczek K, Małyszko J Abstract Nephrectomy, which constitutes a gold-standard procedure for the treatment of renal-cell carcinoma (RCC), has been widely discussed in the past decade as a significant risk factor of the development of chronic kidney disease (CKD). RCC is the third most common genitourinary cancer in the United States, with an estimated more than 65,000 new cases and 14,970 deaths. The aim of this review was to precisely and comprehensively summarize the status of current knowledge in chronic kidney disease risk factors after nephrectomy, the advantages of minimally invasive vs. radical nephrectomy, post-nephrectomy biomarkers of CKD, ways of post-operative chronic kidney disease prevention and, therefore, better understand why various aspects of CKD after nephrectomy. The majority of current studies indicated a better long-term kidney function preservation in patients undergoing partial nephrectomy in comparison to those after radical nephrectomy. Furthermore, a nephron-sparing surgery should be a preferred first-line procedure among young patients with small renal masses. As partial nephrectomy is followed by a greater risk of adverse outcomes relative to radical nephrectomy, a potential survival benefit should...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research

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Conclusion: PN is associated with a higher OS rate and better kidney function in patients with preoperative CKD stage I and II, but not in those with CKD stage III. PMID: 30344463 [PubMed - in process]
Source: Journal of Korean Medical Science - Category: Biomedical Science Tags: J Korean Med Sci Source Type: research
Publication date: Available online 24 September 2018Source: European UrologyAuthor(s): Boris Gershman, R. Houston Thompson, Stephen A. Boorjian, Christine M. Lohse, Brian A. Costello, John C. Cheville, Bradley C. LeibovichAbstractBackgroundNephron-sparing surgery is the preferred surgical management of cT1 renal masses, but observational and randomized data conflict regarding a survival benefit.ObjectiveTo examine the associations of radical nephrectomy (RN) versus partial nephrectomy (PN) with oncologic and nononcologic outcomes.Design, setting, and participantsA total of 2459 adults were treated with RN or PN between 199...
Source: European Urology - Category: Urology & Nephrology Source Type: research
ConclusionsIn patients undergoing surgery for RCC, renal function should be preserved in order to improve cancer-related survival.Patient summaryThe relationship between renal function and probability of dying due to renal cancer is complex. The present study found a correlation between glomerular filtration rate and cancer specific mortality that could reconsider the oncological role of renal function in patients undergoing surgery for renal cancer.
Source: European Urology - Category: Urology & Nephrology Source Type: research
Authors: Yuki H, Kamai T, Murakami S, Higashi S, Narimatsu T, Kambara T, Betsunoh H, Abe H, Arai K, Shirataki H, Yoshida KI Abstract Chronic kidney disease (CKD) is a worldwide health problem, and prevention of CKD is important for preservation of renal function after kidney surgery. There is evidence that transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) has a vital antioxidant and detoxifying role in protecting the kidneys against various diseases. Impaired activation of Nrf2 is associated with oxidative stress related to CKD, and Nrf2 is also a key player in the development of cancer. Howev...
Source: Oncotarget - Category: Cancer & Oncology Tags: Oncotarget Source Type: research
Partial nephrectomy (PN) for clinically localized renal cell carcinoma (CLRCC) allows for comparable oncologic benefit to radical nephrectomy with improved preservation of renal function in pT1-T2 masses. The decreased impact on GFR in patients within normal or near normal renal function is less important than the change observed in those patients with chronic kidney disease (CKD). We aimed to investigate the rates and risk factors for CKD upstaging after PN in patients with normal and at-risk kidneys, and to understand how surgically modifiable factors influence that relationship.
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Tags: Kidney Cancer: Localized: Surgical Therapy VI Source Type: research
Though radical cytoreductive nephrectomy has been shown to improve overall survival in patients with metastatic renal cell carcinoma, the impact this treatment has on renal function has not been adequately assessed. Radical nephrectomy in patients with localized cancer has been associated with risk of chronic kidney disease development. Using patients enrolled in ADAPT trial that received cytoreductive nephrectomy in the metastatic setting, we intend to study the effect of this procedure on overall renal function in patients without kidney disease.
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Tags: Kidney Cancer: Localized: Surgical Therapy IV Source Type: research
In this study, we examined the associations of RN versus PN with oncologic and non-oncologic outcomes using a large institutional cohort.
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Tags: Kidney Cancer: Localized: Surgical Therapy V Source Type: research
lli A Abstract INTRODUCTION: There is a lack of validated quality metrics to evaluate the care of patients receiving surgery for renal cell carcinoma (RCC). To address this, the Kidney Cancer Research Network of Canada defined a list of quality indicators (QI) to assess hospital-level performance. We have case-mix adjusted these QIs to benchmark RCC surgical care at Canadian academic centres. METHODS: The Canadian Kidney Cancer information system (CKCis) was used to measure six QIs: laparoscopic approach proportion (LA), partial nephrectomy proportion (PN), partial nephrectomy in patients with chronic kidney ...
Source: Canadian Urological Association Journal - Category: Urology & Nephrology Authors: Tags: Can Urol Assoc J Source Type: research
Conclusions: Whenever feasible, PN should be considered for renal masses ≥4 cm, as this technique shows better long-term results regarding disease-specific survival and renal function preservation in our study group.Urol Int
Source: Urologia Internationalis - Category: Urology & Nephrology Source Type: research
This study describes the natural history of renal function after radical and partial nephrectomy and explores factors associated with postoperative decline in renal function. METHODS: This is a multi-institutional cohort study of patients in the Canadian Kidney Cancer Information System who underwent partial or radical nephrectomy for RCC. Estimated glomerular filtration rate (eGFR) and stage of chronic kidney disease were determined preoperatively and at 3, 12, and 24 months postoperatively. Linear regression was used to determine the association between postoperative eGFR and type of surgery (radical vs. partial), d...
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
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