Single Kidney Outcome Similar With Nephrectomy, Ablation

Short-term renal function outcomes similar with nephrectomy, ablation for tumors in solitary kidney

MONDAY, Oct. 17 (HealthDay News) -- For patients with a tumor in a solitary kidney, short-term renal function outcomes are similar for treatment with partial nephrectomy or percutaneous ablation, according to a study published in the November issue of The Journal of Urology.

Christopher R. Mitchell, from the Mayo Medical School and Mayo Clinic in Rochester, Minn., and colleagues investigated the impact of partial nephrectomy and percutaneous ablation on renal function in patients with a solitary kidney. Between 2003 and 2009, 50 patients who underwent percutaneous ablation and 65 who underwent partial nephrectomy were included. Preoperative characteristics and three-month post-treatment renal function were compared in the two groups.

The investigators found that, with partial nephrectomy, a median of 18 minutes of warm ischemia was used in 10 percent, a median of 28 minutes of cold ischemia was used in 42 percent, and no ischemia was used in 48 percent of patients. Compared to patients undergoing ablation, those undergoing partial nephrectomy were significantly younger (age 62.5 versus 68.5 years) and had significantly larger tumors (median 3.5 versus 2.5 cm), with significantly higher nephrometry scores (median 9 versus 7). The two groups showed no significant differences in glomerular filtration rate, change in glomerular filtration rate, or change in chronic kidney disease stage at three-months post-treatment. Multivariate analysis, adjusting for age, tumor size, and nephrometry score, yielded similar results.

"In patients with a solitary kidney we found that percutaneous thermal ablation and partial nephrectomy were associated with equivalent short-term renal function preservation," the authors write.

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