title: Chronic kidney disease after nephrectomy in patients with small renal masses: a retrospective observational analysis.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a worldwide health threat associated with increased cardiovascular disease and mortality.
  
  
  OBJECTIVE
  To examine postoperative CKD in patients with small renal masses (SRMs) treated with partial nephrectomy (PN) or radical nephrectomy (RN).
  
  
  METHODS
  A US National Cancer Institute Surveillance Epidemiology and End Results (SEER)-Medicare-linked retrospective cohort of 4633 T1aN0M0 renal cell carcinoma (RCC) patients who underwent PN or RN.
  
  
  METHODS
  The primary outcome of interest was the onset of CKD stage ≥3. Secondary end points comprised acute renal failure (ARF), chronic renal insufficiency (CRI), anemia in CKD, and end-stage renal disease (ESRD). Kaplan-Meier and Cox regression analyses were performed.
  
  
  CONCLUSIONS
  Postpropensity matching resulted in 840 RN and PN patients. In multivariable analyses, RN patients were 1.9-, 1.4-, 1.8-, and 1.8-fold more likely to have an occurrence of CKD, ARF, CRI, and anemia in CKD, respectively (all p ≤ 0.004). The risk of ESRD between treatment groups failed to achieve statistical significance (p=0.06).
  
  
  CONCLUSIONS
  PN is associated with more favorable postoperative renal function outcomes relative to RN in the setting of SRMs.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada. mcw.sun@umontreal.ca
authors.forename: Maxine
authors.initials: M
authors.lastname: Sun
authors.forename: Marco
authors.initials: M
authors.lastname: Bianchi
authors.forename: Jens
authors.initials: J
authors.lastname: Hansen
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.forename: Firas
authors.initials: F
authors.lastname: Abdollah
authors.forename: Zhe
authors.initials: Z
authors.lastname: Tian
authors.forename: Jesse
authors.initials: J
authors.lastname: Sammon
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
mesh_terms: D000368:Aged; D000740:Anemia / Q000209:etiology; D002292:Carcinoma, Renal Cell / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D012189:Retrospective Studies; D012306:Risk; D018426:SEER Program; D016896:Treatment Outcome