Improvement in the diagnostic imaging techniques has made possible the early-stage detection of small renal cell carcinoma. The surgeons prefer to perform partial nephrectomy in such cases over the radical nephrectomy to preserve the renal function to the possible extent. CKD may occur postoperatively but it is difficult to determine the risk of CKD due to the involvement of various predisposing factors with different long- and short-term effects.

The authors of the study wrote, “The present study aimed to determine the effect of an increasing number of predisposing atheroembolic risk factors on the development of chronic kidney disease (CKD) after partial nephrectomy (PN) in patients with T1-stage renal cell carcinoma (RCC).”

A total of 147 patients with T1-stage RCC were included in the study. The patients have normal kidneys without preoperative chronic kidney disease. The patients underwent laparoscopic (64 patients) or open (83 patients) partial nephrectomy. The researchers determined the predictive factors for CKD between open partial nephrectomy and laparoscopic partial nephrectomy from various clinicopathological features.

The follow-up period for the study was 42 months. The rate of postoperative chronic kidney disease was 11.6%. There was a significant difference in CKD-free survival among patients with atheroembolic risks 5-7, 3-4, and 1-2. The study concluded that patients with 3 or more predisposing atheroembolic factors have an increased risk of developing chronic kidney disease after partial nephrectomy. The study further reveals that patients who had undergone laparoscopic nephrectomy have less risk of developing CKD as compared to open nephrectomy in patients with 3 or more predisposing atheroembolism risk factors.

Source

Sung Han Kim, Jae Young Joung, Ho Kyung Seo, Kang Hyun Lee, Jinsoo Chung, The effect of predisposing atheroembolic risk factors on renal functional recovery between laparoscopy and open technique in patients with T1-stage renal cell carcinoma who und