Renal function recovery after radical nephrectomy more likely in patients with lower preoperative EGFR
Recovery to preoperative renal function occur within 2 years in a large proportion of patients after undergoing radical nephrectomy for kidney tumours, a recent study has confirmed, adding that recovery is more probable among those with a lower preoperative estimated glomerular filtration rate (EGFR).
Nearly half of the patients (45 percent) had recovered to the preoperative EGFR by 2 years following radical nephrectomy. Renal function recovery also differed based on preoperative renal function, such that those with a lower preoperative EGFR had greater chance of recovery.
Furthermore, female patients and those who had larger tumour size were likely to have a better chance of renal recovery function.
In this multicentre retrospective study, the investigators sought to confirm the findings from a previous single-institution study of 572 patients from Memorial Sloan Kettering Cancer Centre, in which they found that 49 percent of patients recovered to the preoperative EGFR within 2 years following radical nephrectomy for renal cell carcinoma.
A total of 1,928 patients were included in the study, which used data sourced from three independent centres. The primary outcome was postoperative recovery to the preoperative EGFR. The investigators analysed data using cumulative incidence and competing risks regression with death from any cause treated as a competing event.
A Japan study found that patients who had deteriorated renal function immediately after radical nephrectomy recovered over time, but those with chronic kidney disease, diabetes mellitus, cardiovascular disease and hypertension did not tend to recover renal function postoperatively. Independent risk factors for a >50-percent EGFR decrease included greater age and diabetes mellitus. [Int J Urol 2016;23:219-223]