Abstract
The article by Mashni et al looks at more than 2100 patients with clinically localized renal tumors with a normal serum creatinine level and a normal contralateral kidney on imaging. The authors update their previous experience from 2006 1 Huang W.C. Levey A.S. Serio A.M. et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006; 7: 735-740 Abstract Full Text Full Text PDF PubMed Scopus (1316) Google Scholar with larger numbers and longer follow-up, and are now using the more accurate CKD-EPI equation for estimation of glomerular filtration rate (GFR). The basic findings are that 30% of the study population had pre-existing chronic kidney disease (CKD) despite a “normal” serum creatinine, and that radical nephrectomy (RN) was associated with a much greater incidence of de novo CKD after surgery when compared with partial nephrectomy (PN). Overall survival in the RN group was also significantly lower than overall survival in the PN group on multivariable analysis, with a 61% increased risk of death per year in the RN cohort. As such, Mashni et al's article further substantiates their previous work, which increased awareness about the high incidence of unrecognized CKD in the renal cancer population, and highlighted the potential deleterious effects of RN. Their previous article was often quoted and represents one of the landmark studies in the field. 1 Huang W.C. Levey A.S. Serio A.M. et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006; 7: 735-740 Abstract Full Text Full Text PDF PubMed Scopus (1316) Google Scholar
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