EVALUATION OF RENAL FUNCTION IN PATIENTS WITH RENAL CELL CARCINOMA BEFORE AND AFTER RADICAL NEPHRECTOMY
https://doi.org/10.17650/1726-9776-2011-7-4-16-20
Abstract
There is an increase in the number of patients with renal cell carcinoma (RCC) every year. At the same time radical nephrectomy (RN) remains the standard treatment of renal malignancies and the most common surgical procedure for this pathology. A considerable number of patients with kidney cancer have diminished renal function that worsens after removal of functioning kidney tissue together with a tumor. This promotes retained low overall survival rates in patients with RCC, by improving cancer-specific survival. Renal function was studied in 48 patients with RCC prior to and 1 year after RN. In all the patients, glomerular filtration rate (GFR) was estimated using the Cockroft-Gault equation with and without protein load. Renal parenchyma volume was calculated by spiral computed tomography. Patients aged over 60 years had decreased baseline renal function as compared to those aged under 60 years (GFR 77.4 versus 103.6 ml/min/1.73 m2). The postoperative reduction in female renal function was more pronounced (GFR, 84.92 versus 92.54 ml/min/1.73 m2). Patients with metastatic RCC had lower baseline renal function and its significant postoperative loss than those with the non-metastatic forms of a tumor. A load test showed a substantially decreased renal reserve in patients with RCC.
About the Authors
M. I. KoganRussian Federation
A. A. Gusev
Russian Federation
S. V. Evseyev
Russian Federation
References
1. Gupta K., Miller J.D., Li J.Z. et al. Epidemiologic and socioeconomic burden of metastatic renal cell carcinoma (mRCC): a literature review. Cancer Treat Rev 2008; 34:193–205.
2. Jemal A., Siegel R., Ward E. et al. Cancer statistics, 2009. CA Cancer J Clin 2009; 59:225–49.
3. Чиссов В.И., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2008 году. М., 2010.
4. Гусев А.А., Медведев В.Л., Шангичев А.В. и др. Оценка течения инцидентального и симптомного почечно-клеточного рака после радикального лечения. Онкоурология 2006;(4):18−24.
5. Dulabon L.M., Lowrance W.T., Russo P. et al. Trends in renal tumor surgery delivery within the United States. Cancer 2010; 116:2316.
6. Novick A.C., Campbell S.C., Belldegrun A. et al. Guideline for мanagement of the сlinical stage 1 renal mass. J Urol 2009;182:1271.
7. Kim H.L., Shah S.K., Tan W., Shikanov S.A. et al. Estimation and prediction of renal function in patients with renal tumor. J Urol 2009; 181:2451−61.
8. Lopes N.H., Paulitsch F.S., Pereira A. et al. Mild chronic kidney dysfunction and treatment strategies for stable coronary artery disease. J Thorac Cardiovasc Surg 2009;137:1443−9.
9. Jeon H.G., Jeong I.G., Lee J.W. et al. Prognostic factors for chronic kidney disease after curative surgery in patients with small renal tumors. Urology 2009; 74:1064–9.
10. Go A.S., Chertow G.M., Fan D. et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004;351: 1296−306.
11. Lane B.R., Poggio E.D., Herts B.R. et al. Renal function assessment in the era of chronic kidney disease: renewed emphasis on renal function centered patient care. J Urol 2009;182:435−44.
12. Huang W.C., Levey A.S., Serio A.M. et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 2006; 7:735−40.
13. Levey A.S., Coresh J., Balk E. et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003;139:137−47.
14. Clark M.A., Shikanov S.A., Raman J.D. et al. Chronic kidney disease before and after partial nephrectomy. J Urol 2011;185:43−8.
15. Lucas S.M., Stern J.M., Adibi M. et al. Renal function outcomes in patients treated for renal masses smaller than 4 centimetres by ablative and extirpative techniques. J Urol 2008;179:75−9.
16. Funahashi Y., Hattori R., Yamamoto T. et al. Relationship between renal parenchymal volume and single kidney glomerular filtration rate before and after unilateral nephrectomy. Urology 2011;77:1404–8.
17. Lane B.R., Fergany A.F., Weight C.J., Campbell S.C. Renal functional outcomes after partial nephrectomy with extended ischemic intervals are better than after radical nephrectomy. J Urol 2010;184:1286−90.
18. Demirjian S., Weight C.J., Larson B.T. et al. Performance of the chronic kidney diseaseepidemiology study equations for estimating glomerular filtration rate before and after nephrectomy. J Urol 2010;183:896−902.
Review
For citations:
Kogan M.I., Gusev A.A., Evseyev S.V. EVALUATION OF RENAL FUNCTION IN PATIENTS WITH RENAL CELL CARCINOMA BEFORE AND AFTER RADICAL NEPHRECTOMY. Cancer Urology. 2011;7(4):16-20. (In Russ.) https://doi.org/10.17650/1726-9776-2011-7-4-16-20