October 2015 Vol. 3 No.10

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Original Research Article

Comparison of Glomerular Filtration Rate (GFR) Changes in Radical Nephrectomy versus Nephron Sparing Surgery (NSS) for pT1 Renal Cell Carcinoma (RCC)

^*Phukan C, Venkatramani V, Banerji JS, Kekre NS and Devasia A

Department of Urology, Christian Medical College, Vellore

*Corresponding Author’s Email: drchandanph@yahoo.com
Tel - +91-416-2282055; +91- 9442152347

Accepted October 12, 2015

Abstract

To determine the impact of nephron sparing surgery (NSS) versus radical nephrectomy (RN) on the glomerular filtration rate (GFR) in pT1 renal cell carcinoma (RCC). All patients with renal tumors (pT1) who underwent either NSS or RN between 2004 and 2011 were studied retrospectively. GFR, chronic kidney disease (CKD) stage and serum creatinine were studied pre-operatively, and post-operatively. Of 341 patients, 77 underwent NSS and 264 underwent RN. Mean GFR was 75 and 76 ml/min/1.73m² pre-operatively in the NSS and RN group. There was a statistically significant reduction in GFR in the RN versus NSS group in the immediate postoperative period (p=0.008), at three months (p=0.001) and at one year (p=0.001). On multivariate analysis it was seen that hypertension and radical nephrectomy were predictors of significant worsening of GFR at one year. There was a significant change of CKD stage from stage I/II to CKD III-V at one year in the RN versus NSS group (p=0.043). Radical nephrectomy was associated with a significant fall in GFR when compared to NSS even on multivariate analysis. Nephron sparing surgery is important in the treatment of pT1RCC to preserve renal function.

Keywords: Glomerular Filtration Rate, Nephron sparing surgery, Radical nephrectomy, Renal Cell Carcinoma