Factors associated with contralateral renal parenchymal volume changes after partial nephrectomy: A retrospective...

Area of Science:

• Nephrology
• Urology
• Oncology

Background:

• Renal cell carcinoma (RCC) is a common malignancy.
• Partial nephrectomy (PN) is a standard treatment for localized RCC, preserving renal function.
• Assessing compensatory changes in the contralateral kidney after PN is crucial for long-term renal health.

Purpose of the Study:

• To evaluate changes in contralateral renal parenchymal volume (CRPV) after PN in RCC patients.
• To identify clinical factors associated with CRPV increase post-PN.

Main Methods:

• Retrospective analysis of 143 RCC patients who underwent PN.
• Preoperative and postoperative CRPV assessment using 3D Slicer software.
• Logistic regression analysis to identify predictors of CRPV increase.

Main Results:

• A median CRPV increase of 4.1% was observed, with 68.5% of patients showing enlargement.
• Postoperative acute kidney injury (AKI) was a significant independent predictor of CRPV increase (OR=2.990, p=0.040).
• Preexisting hypertension was inversely associated with CRPV growth (OR=0.446, p=0.041).

Conclusions:

• Contralateral renal compensation after PN is modest.
• Postoperative AKI is associated with compensatory renal hypertrophy.
• Hypertension negatively impacts compensatory renal growth, highlighting the need for perioperative renal function and blood pressure management.