Impact on Renal Function of Percutaneous Thermal Ablation of Renal Masses in Patients with Preexisting Chronic Kidney Disease

Abstract

Purpose To examine the effect of percutaneous thermal ablation of renal masses on renal function among patients with baseline chronic kidney disease (CKD). Materials And Methods Patients with baseline CKD (initial glomerular filtration rate [GFR] < 60 mL/min/1.73 m 2) who underwent percutaneous cryoablation or radiofrequency (RF) ablation of renal masses were reviewed. Results A total of 48 patients with a GRF of 60 mL/min/1.73 m 2 or lower were treated with renal cryoablation or RF ablation and had follow-up GFR measurement 1 month afterward. Mean patient age was 73 years (range, 47–89 y). Cryoablation was performed in 22 patients and RF ablation was performed in 26. Mean tumor diameter was 3.4 cm (range, 0.9–10.2 cm). Mean overall GFRs were 39.8 mL/min/1.73 m 2 at baseline and 39.7 mL/min/1.73 m 2 at 1 month after ablation ( P = .85). A total of 38 patients had 1-year follow-up GFR measurement (cryoablation, n = 18; RF ablation, n = 20), and their mean GFR was 40.9 mL/min/1.73 m 2 ± 11.4 (SD), compared with a preablation GFR of 41.2 mL/min/1.73 m 2 ( P = .79). In the cryoablation group, mean GFRs at 1 month and 1 year were 41.4 mL/min/1.73 m 2 and 44.4 mL/min/1.73 m 2, compared with respective baseline GFRs of 41.1 mL/min/1.73 m 2 and 42.1 mL/min/1.73 m 2 ( P = .75 and P = .19, respectively). In the RF ablation group, mean GFRs at 1 month and 1 year were 38.2 mL/min/1.73 m 2 and 37.8 mL/min/1.73 m 2, compared with respective baseline GFRs of 38.7 mL/min/1.73 m 2 and 40.4 mL/min/1.73 m 2 ( P = .58 and P = .09, respectively). Conclusions Independent of ablation modality, percutaneous renal mass ablation does not appear to affect renal function among patients with CKD.