Optimising assessment of kidney function when managing localised renal masses

Area of Science:

• Nephrology
• Urology
• Oncology

Background:

• Renal mass lesion management is evolving due to early detection and technological advancements.
• Radical nephrectomy was historically standard, but partial nephrectomy is now recommended for localized masses.
• Ablative renal surgery carries a significant risk of chronic kidney disease.

Purpose of the Study:

• To review the evolving management strategies for renal mass lesions.
• To highlight the long-term renal outcomes of various surgical interventions.
• To advocate for improved patient monitoring and risk stratification for chronic kidney disease.

Main Methods:

• Review of current literature on renal mass management.
• Analysis of surgical techniques including radical nephrectomy, partial nephrectomy, and ablation.
• Assessment of long-term renal outcomes and chronic kidney disease risks.

Main Results:

• Partial nephrectomy offers favorable renal functional outcomes compared to radical nephrectomy.
• Limited data exists on long-term outcomes for nephrectomy and ablation therapies.
• Management decisions often assume malignancy, impacting treatment choices for benign lesions.

Conclusions:

• Improved strategies for kidney function assessment and risk stratification are needed.
• Early, targeted referral and regular chronic kidney disease screening are recommended for post-surgery patients.
• The review applies to both benign and malignant renal mass lesions, emphasizing kidney preservation.