title: Risk of end-stage renal disease after cancer nephrectomy in Taiwan: a nationwide population-based study.
abstract: BACKGROUND
  The conclusions of population-based studies examining the risk of developing end-stage renal disease (ESRD) after nephrectomy among patients with renal cell carcinoma (RCC) remain inconclusive. In this study, we sought to examine whether patients with RCC undergoing radical nephrectomy (RN) have higher risk of ESRD compared to those undergoing partial nephrectomy (PN).
  
  
  METHODS
  Nationwide population-based retrospective cohort of 7670 patients with RCC who underwent RN or PN between 2000 and 2011 as recorded in the Taiwan National Health Insurance in-patient claims data were analyzed. The primary outcome of interest was the occurrence of ESRD requiring regular renal hemodialysis. Multivariable Cox proportional hazard regression model was performed to assess the risk.
  
  
  RESULTS
  The median follow-up for the post-propensity matched cohort (1212 PN and 2424 RN) was 48 months. Seventy patients (2.9%) developed ESRD among those who underwent RN, for an incidence rate of 6.9 cases per 1000 person-years. In contrast, only 23 patients (1.9%) developed ESRD among patients who underwent PN, for an incidence rate of 5.5 cases per 1000 person-years. Despite the higher incidence rate of ESRD among RN, the aIRR (RN/PN) was 1.26 (95% CI 0.78-2.01), which was not statistically significant.
  
  
  CONCLUSIONS
  This Taiwan nationwide population-based study suggests that patients with RCC undergoing RN do not have significantly higher risk of developing ESRD compared to those undergoing PN.
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Chang  Gung University of Science and Technology, Chia-Yi, Taiwan and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Wei-Yu
authors.initials: WY
authors.lastname: Lin
authors.affiliation: NCKU Research Center for Health Data and Department of Public Health, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Fu-Wen
authors.initials: FW
authors.lastname: Liang
authors.affiliation: NCKU Research Center for Health Data and Department of Public Health, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Tsung-Hsueh
authors.initials: TH
authors.lastname: Lu
mesh_terms: D002292:Carcinoma, Renal Cell / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology*; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology