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Long-term assessment of renal function following nephrectomy for stage I renal carcinoma
H B Grossman1, D Sommerfield, J W Konnak
1Department of Surgery, University of Michigan, Ann Arbor.
Objective:
To evaluate the impact of nephrectomy on renal function in people who are potential candidates for nephron sparing surgery, i.e. partial nephrectomy.
Patients And Methods:
A retrospective analysis was carried out of 109 patients (35 women, 74 men) who had undergone a nephrectomy for stage I renal carcinoma at the University of Michigan between 1960 and 1979. All patients had a functioning contralateral kidney and had undergone at least one post-operative serum creatinine evaluation. Statistical analysis was by Pearson's correlation coefficient.
Results:
One individual developed a transitional cell carcinoma in the remaining renal pelvis and was treated with nephroureterectomy. No other patient progressed to dialysis. Five patients had post-operative serum creatinine levels from 221 to 354 mumol/l, one of whom had undergone both a nephrectomy and a partial nephrectomy for bilateral renal tumours. The remaining four had renal disease including diabetes, hypertension, pyelonephritis and renal artery stenosis. There was a strong association between pre-operative and post-operative serum creatinine values.
Conclusion:
Patients with low stage renal tumours and a normal contralateral kidney are at low risk of progression to renal failure.