Long-term consequence of renal function following nephrectomy for renal cell cancer.
OBJECTIVE
A retrospective analysis was performed involving patients who had undergone radical nephrectomy for renal cell cancer to determine the long-term outcome of this surgery on renal status.


METHODS
Between 1977 and 2001, 172 patients having undergone radical nephrectomy for renal cell cancer were followed for a period of more than one year at the Department of Urology Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan. The preoperative and postoperative serum creatinine values of these individuals were reviewed. Long-term effects of radical nephrectomy on renal function and factors influencing postoperative renal dysfunction were analyzed.


RESULTS
Six (3.5%) of the 172 individuals progressed to hemodialysis. Eleven (6.4%) patients displayed serum creatinine values of > or =1.6 mg/dL. The remaining 155 patients (90.1%) demonstrated postoperative serum creatinine values of <1.6 mg/dL. The present study suggests that aging, a high degree of proteinuria, hypertension and diabetes mellitus were the predominant risk factors for renal deterioration following nephrectomy.


CONCLUSIONS
We have primarily selected radical nephrectomy for cases exhibiting smaller renal tumors with a normal contralateral kidney. We encourage nephron-sparing surgery where possible in patients displaying risk factors, including a high degree of proteinuria, hypertension, or diabetes mellitus.
Shirasaki
Yoshinori
Y
Department of Urology, Okayama University Medical School, 2-5-1 Shikata, Okayama 700-8558, Japan. batton@mub.biglobe.ne.jp
Tsushima
Tomoyasu
T
Nasu
Yasutomo
Y
Kumon
Hiromi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D003928:Diabetic Nephropathies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000209:etiology; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011184:Postoperative Period; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors
D003404:Creatinine