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

The objective of this study is to assess contralateral renal parenchymal volume (CRPV) changes in patients with renal cell carcinoma (RCC) after PN and identify the clinical factors associated with CRPV increase.

This retrospective study included 143 RCC patients (aged 24-76 years) who underwent PN between 2017 and 2018. Preoperative and postoperative CRPV were assessed using 3D Slicer software. Patients were categorized into CRPV-increase and CRPV-decrease groups based on volumetric changes. Univariate and multivariable logistic regression analyses were conducted to determine independent factors influencing CRPV increase.

With a median follow-up of 904 days (IQR: 605-1707), the overall median CRPV increase was 4.1% (IQR: -2.8% to 12.6%) relative to the preoperative volume, and 68.5% (98/143) of patients exhibited CRPV enlargement. Multivariable analysis identified postoperative acute kidney injury (AKI) as a significant independent predictor associated with CRPV increase (OR = 2.990, 95% CI: 1.050-8.513, p = 0.040), whereas preexisting hypertension was inversely associated with CRPV growth (OR = 0.446, 95% CI: 0.206-0.966, p = 0.041).

Contralateral renal compensation following PN is relatively modest compared to radical nephrectomy. Postoperative AKI is associated with compensatory renal hypertrophy, whereas hypertension is negatively associated with this process. These hypothesis-generating findings underscore the importance of perioperative renal function management and blood pressure control. Prospective studies are needed to validate these associations.