EVALUATION OF RENAL FUNCTIONS AND SURGICAL TREATMENT FOR RENAL CELL CARCINOMA

The main goal in the treatment of kidney tumors is to preserve renal function. Investigations made in the past decades show that chronic kidney diseases (CKD) are much more common than formerly estimated and conventional methods for evaluating renal function frequently reduce the incidence of CKD having more serious consequences than recognized before. CKD leads to renal dysfunction subsequently resulting in renal failure that increases a risk for the development and progression of cardiovascular diseases. Formulas for calculation of glomerular filtration rate on the basis of serum creatinine are presently in common use to evaluate renal function. The MDRD and Cockcroft-Gault formulas are most frequently used. Investigations dealing with the radiological estimation of renal volumes and function are also promising. In patients with renal cell carcinoma (RCC), the differences in cancer-specific and overall survival become significant just 3 years after surgery. Decreased renal function after surgical renal tissue removal in the presence of CKD is one of the significant reasons for no positive changes in the overall survival of patients with RCC. According to the data of different studies, the concurrence of RCC and CKD, which cause diminished renal function, is encountered in a considerable number of patients. Thus, the present-day treatment of patients with RCC should be focused on the optimization of renal function, the prevention of CKD, and the minimization of its degree. Researches to improve renal function in RCC patients who have undergone surgery are regarded as the priorities of urologic oncology.

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