Renal Function after Nephrectomy: To Examine any Differences Between Kidney Cancer and Kidney Donation

Abstract

Objective: To evaluate renal function after radical nephrectomy (RN) and donor nephrectomy (DN), and the differences in changes and identify factors that lead to chronic renal failure. Material and Methods: A retrospective review of patients diagnosed with renal cell carcinoma, who received RN and donors of living kidney transplantation. Kidney function in both groups was measured before and after surgery. We assessed the donors’ kidney functions using an estimated Glomerular filtration rate (eGFR), through a Modification of Diet in Renal Disease (MDRD) formula [GFR = 186 x serum creatine-1.154 age-0.203 x 0.742 (if the patient was female). Kidney function after surgery was evaluated at 1, 3, 6 and 12 months. Rates of renal function decline were analyzed compared with baseline.Results: A total of 249 patients were included in the study, 50 in the DN group and 199 in the RN group. The mean eGFRs before surgery were 68.6 ml/min/1.73m2 and 88.8 ml/min/1.73m2 in the RN and DN groups, respectively. During the first year postoperatively, renal function in the RN and DN groups decreased by approximately 25.6% and 27.2% from baseline, respectively.Conclusion: Renal function after surgery declined after both RN and DN, but the pattern of changes in renal function was different between the groups, possibly due to the patients in the DN group being younger and healthier. There were no differences in percentage of change in eGFR between the groups at the 1 year follow up.