Long-term chronological changes in renal function and functional renal volume after nephron-sparing surgery: A...

Area of Science:

• Nephrology
• Urology
• Oncology

Background:

• Nephron-sparing surgery is crucial for preserving renal function.
• Understanding long-term changes in renal volume and function post-surgery is vital.
• Identifying factors predicting chronic kidney disease progression is essential.

Purpose of the Study:

• To assess long-term changes in functional renal volume and function after nephron-sparing surgery.
• To identify predictors of chronic kidney disease progression post-surgery.

Main Methods:

• Prospective observational study of 80 patients undergoing nephron-sparing surgery.
• Defined renal function deterioration as ≥20% decrease in estimated glomerular filtration rate (eGFR) at 5 years post-surgery.
• Utilized multivariate analysis to identify associated factors.

Main Results:

• Predicted eGFR based on 5-year functional renal volume strongly correlated with actual eGFR (ρ=0.89, P<0.001).
• Higher incidence of new-onset stage IIIb chronic kidney disease in the deterioration group (P<0.001).
• Independent predictors of deterioration included proteinuria, small preoperative functional renal volume (≤250 mL), and large tumor volume (≥4.5 mL).

Conclusions:

• Functional renal volume significantly impacts long-term renal function post-nephron-sparing surgery.
• Preoperative proteinuria, small renal volume, and large tumor size are associated with renal function decline.
• Close oncological follow-up and medical interventions are recommended to prevent chronic kidney disease progression in high-risk patients.