Risk of chronic kidney disease after cancer nephrectomy.

Lin Li, Wei Ling Lau, Connie M. Rhee, Kevin Harley, Csaba P. Kovesdy, John J. Sim, Steve Jacobsen, Anthony Chang, Jaime Landman, Kamyar Kalantar-Zadeh

Research output: Contribution to journalReview article

21 Citations (Scopus)

Abstract

The incidence of early stage renal cell carcinoma (RCC) is increasing and observational studies have shown equivalent oncological outcomes of partial versus radical nephrectomy for stage I tumours. Population studies suggest that compared with radical nephrectomy, partial nephrectomy is associated with decreased mortality and a lower rate of postoperative decline in kidney function. However, rates of chronic kidney disease (CKD) in patients who have undergone nephrectomy might be higher than in the general population. The risks of new-onset or accelerated CKD and worsened survival after nephrectomy might be linked, as kidney insufficiency is a risk factor for cardiovascular disease and mortality. Nephron-sparing approaches have, therefore, been proposed as the standard of care for patients with type 1a tumours and as a viable option for those with type 1b tumours. However, prospective data on the incidence of de novo and accelerated CKD after cancer nephrectomy is lacking, and the only randomized trial to date was closed prematurely. Intrinsic abnormalities in non-neoplastic kidney parenchyma and comorbid conditions (including diabetes mellitus and hypertension) might increase the risks of CKD and RCC. More research is needed to better understand the risk of CKD post-nephrectomy, to develop and validate predictive scores for risk-stratification, and to optimize patient management.

Original languageEnglish (US)
Pages (from-to)135-145
Number of pages11
JournalNature reviews. Nephrology
Volume10
Issue number3
DOIs
StatePublished - Mar 2014

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Nephrectomy
Chronic Renal Insufficiency
Neoplasms
Renal Cell Carcinoma
Kidney
Mortality
Incidence
Nephrons
Standard of Care
Population
Observational Studies
Renal Insufficiency
Diabetes Mellitus
Cardiovascular Diseases
Hypertension
Survival
Research

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Li, L., Lau, W. L., Rhee, C. M., Harley, K., Kovesdy, C. P., Sim, J. J., ... Kalantar-Zadeh, K. (2014). Risk of chronic kidney disease after cancer nephrectomy. Nature reviews. Nephrology, 10(3), 135-145. https://doi.org/10.1038/nrneph.2013.273

Risk of chronic kidney disease after cancer nephrectomy. / Li, Lin; Lau, Wei Ling; Rhee, Connie M.; Harley, Kevin; Kovesdy, Csaba P.; Sim, John J.; Jacobsen, Steve; Chang, Anthony; Landman, Jaime; Kalantar-Zadeh, Kamyar.

In: Nature reviews. Nephrology, Vol. 10, No. 3, 03.2014, p. 135-145.

Research output: Contribution to journalReview article

Li, L, Lau, WL, Rhee, CM, Harley, K, Kovesdy, CP, Sim, JJ, Jacobsen, S, Chang, A, Landman, J & Kalantar-Zadeh, K 2014, 'Risk of chronic kidney disease after cancer nephrectomy.', Nature reviews. Nephrology, vol. 10, no. 3, pp. 135-145. https://doi.org/10.1038/nrneph.2013.273
Li, Lin ; Lau, Wei Ling ; Rhee, Connie M. ; Harley, Kevin ; Kovesdy, Csaba P. ; Sim, John J. ; Jacobsen, Steve ; Chang, Anthony ; Landman, Jaime ; Kalantar-Zadeh, Kamyar. / Risk of chronic kidney disease after cancer nephrectomy. In: Nature reviews. Nephrology. 2014 ; Vol. 10, No. 3. pp. 135-145.
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