Change in renal function post-nephrectomy for renal cell carcinoma in patients with and without hypertension and/or diabetes

  • J John Walter Sisulu University
  • M Henry University of Cape Town
  • A Ringoir University of Cape Town
  • G Pinto University of Cape Town
  • K Kesner Walter Sisulu University
  • J Lazarus University of Cape Town
  • S Sinha University of Cape Town
Keywords: renal cell carcinoma, RCC, nephrectomy, estimated glomerular filtration rate, CKD

Abstract

Background: The standard of care for surgically resectable disease renal cell carcinoma (RCC) is a nephrectomy. Post nephrectomy, these patients are at risk for the development of new onset chronic kidney disease or the progression of pre-existing chronic kidney disease. We aimed to report the changes in renal function in patients who had a nephrectomy for RCC.

Methods: This retrospective, descriptive, cross-sectional study identified 137 patients who had a nephrectomy for RCC from 1 January 2009 to 31 December 2017. The pre-nephrectomy and post-nephrectomy estimated glomerular filtration rate (eGFR) and the histological subtype of RCC on histopathological analysis of the resected specimen were recorded from the National Health Laboratory Services online results platform. All analyses were conducted using SPSS (Version 25) and the significance level was set at p < 0.05.

Results: After a mean follow-up period of 26.5 ± 22 months (median = 19 months), the patients’ eGFR dropped by a mean of 4.82 ± 8.67 ml/min/1.73 m2 (95% CI 3.23–6.41) post-nephrectomy. The mean eGFR fall in patients’ who had hypertension and/or diabetes (n = 63) was significantly larger compared to patients who had neither of these comorbidities (n = 54; p < .001; mean = 7.30 ± 8.40 ml/min/1.73 m2 (95% CI 5.19–9.42) and 1.93 ± 8.14 ml/min/1.73 m2 (95% CI 0.30–4.15) respectively.

Conclusions: The decline in renal function in patients with hypertension and/or diabetes mellitus is more pronounced than in patients with neither of these comorbidities. In these high-risk patients, measures must be taken to prevent the development and limit the progression of chronic kidney disease.

Author Biographies

J John, Walter Sisulu University

Department of Urology, Walter Sisulu University and Frere Hospital and Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa

M Henry, University of Cape Town

Centre for Higher Education Development, University of Cape Town, South Africa

A Ringoir, University of Cape Town

Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa

G Pinto, University of Cape Town

Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa

K Kesner, Walter Sisulu University

Department of Urology, Walter Sisulu University and Frere Hospital, South Africa

J Lazarus, University of Cape Town

Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa

S Sinha, University of Cape Town

Division of Urology, Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa

Published
2020-06-29
How to Cite
John, J., Henry, M., Ringoir, A., Pinto, G., Kesner, K., Lazarus, J., & Sinha, S. (2020). Change in renal function post-nephrectomy for renal cell carcinoma in patients with and without hypertension and/or diabetes. South African Journal of Surgery, 58(02), 101-104. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/3091
Issue
Vol 58 No 2 (2020)
Section
Urology

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