Early functional outcomes of nephron sparring surgery for renal masses in the solitary kidney

Background. Tumors of a solitary kidney (SK) are extremely rare. They are an absolute indication for organ-preserving treatment. Decrease in the glomerular filtration rate (GFR) and development of acute kidney injury in early postoperative period often require hemodialysis, and patients have to stay in the ICU.

Objective. Evaluation of short-term functional results and identification of factors affecting GFR decrease in the early postoperative period after partial nephrectomy for renal masses in the SK.

Materials and methods. Analysis of patients’ data with tumor of the SK who underwent open partial nephrectomy at the Oncourology Department of the N.N. Alexandrov National Cancer Centre ofBelarus in the period of 16 years was performed. The study included 136 patients.

Results. Multifactor regression analysis (including potential risk factors) revealed that the GFR decrease in the early postoperative period significantly correlated with multifocality (p = 0.028-), ischemia (p < 0.001), blood transfusion (p < 0.001), and the maximum tumor size (p = 0.006). Additional analyses didn’t show any statistically significant correlations between decrease of kidney function and duration of the SK status (n = 127; p = 0.31) or the volume of preserved parenchyma (n = 82; p = 0.77).

Conclusion. Early GFR decrease after partial nephrectomy of the SK is strongly associated with ischemia time, blood transfusion, tumor size, and multifocality. In this study, the volume of preserved parenchyma didn’t affect early functional results of the surgery.