Residual renal function after partial or radical nephrectomy for renal cell carcinoma |
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| Authors: | David Chapman Ron Moore Scott Klarenbach Branko Braam |
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| Affiliation: | *Department of Medicine, Division of Nephrology and Immunology, University of Alberta, Edmonton, AB;;†Department of Surgery, Division of Urology, University of Alberta, Edmonton, AB;;‡Department of Oncology, University of Alberta, Edmonton, AB;;§Department of Physiology, University of Alberta, Edmonton, AB |
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| Abstract: | Renal cell carcinoma (RCC) is often detected incidentally and early. Currently, open partial nephrectomy and laparoscopic total nephrectomy form competing technologies. The former is invasive, but nephron-sparing; the other is considered less invasive but with more loss of renal mass. Traditionally, emphasis has been placed on oncologic outcomes. However, a patient with an excellent oncologic outcome may suffer from morbidity and mortality related to renal failure. Animal models with hypertension and diabetic renal disease indicate accelerated progression of pre-existing disease after nephrectomy. Patients with RCC are older and they have a high prevalence of diabetes and hypertension. The progression of renal failure may also be accelerated after a nephrectomy. Our analysis of the available literature indicates that renal outcomes in RCC patients after surgery are relatively poorly defined. A strategy to systematically evaluate the renal function of patients with RCC, with joint discussion between the nephrologist and the oncologic team, is strongly advocated. |
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