Benedito Pereira¹’³, Patricia Jacob³, Nathalia Soldi³, Ariane Garcia³, Larissa Fatel³, Beatriz Pinedo³, Stenio Zequi², Gustavo Guimarães², Germana Brito¹, Joubert Alves¹, Mariana Imanishe¹
¹ Nephrology, AC Camargo Cancer center, Sao Paulo, Brazil,
² Urology, AC Camargo Cancer Center, Sao Paulo, Brazil and
³ Nephrology, Universidade Nove de Julho, Sao Paulo, Brazil
Renal cell carcinoma (CRC) is the 9th most common cancer in the world and its preferential treatment is partial nephrectomy (PN) in order to preserve more renal tissue and, consequently, its function. The amount of renal function preserved using this surgical method is still not well established and there may be the development of chronic kidney disease (CKD) even with PN. Aims: to evaluate the renal function of patients submitted to PN for localized renal tumors; to analyze the risk factors for progression of CKD in the postoperative period (PO) of PN.
A retrospective cohort study was carried out in which 85 patients underwent PN from 2009 to 2014, with name, age, gender, body mass index (BMI), type of surgical approach, type of tumor, associated morbidities, smoking habits and alcoholism, serum creatinine, and the glomerular filtration rate (eGFR) was evaluated in the preoperative period and in the 3rd month of the PO. The data were described in absolute and relative frequencies. Outcomes were described by the Pearson method. To verify differences in frequency of outcomes, Pearson’s Chi-square test or Fisher’s exact test was used. For the characteristics associated with the outcome, the odds ratios and their confidence intervals were calculated. The results were considered significant when p <0.05.
previous diagnosis of CKD was observed in 41.2% of the patients. There was a significant increase in creatinine values and a significant reduction of eGFR in the 3rd PO month. 13 new cases of CKD were found in the 3rd PO period, while 17.1% of the patients progressed in the disease. The presence of perirenal adipose tissue, structural invasion, tissue changes, bleeding and the need for ICUs in the 3rd month of the OP were directly proportional to the progression of CKD.
there was progression of the stage in patients who had previous CKD to PN. PN also caused new cases of CKD. Neoplastic invasion in perirenal adipose tissue and tissue-specific changes in peri-tumor tissue have shown significant associations with the combined outcome of CKD progression.