Between 2009 and 2014 in Queensland, Australia, one in three patients whose kidney cancer was managed with radical nephrectomy developed ESKD, while one in 100 patients managed with partial nephrectomy developed ESKD within a year of undergoing surgery, according to recently published findings.
Robert J. Ellis, BHSc, of the departments of nephrology and urology at Princeton Alexandria Hospital in Brisbane, Australia, and colleagues reviewed the Queensland Cancer Registry to identify patients seen at 43 hospitals and who had any kind of newly diagnosed cases of kidney cancer (n=2,739) between January 2009 and December 2014. ICD-10 codes were used to identify patients who developed ESKD during the study. Researchers calculated incidence rate and 3-year cumulative incidence, and used multivariable Cox proportional hazards models to ascertain factors linked to ESKD.
Researchers found that in all patients, the incidence rate of ESKD was 4.9 per 1,000 patient-years. A total of 68 patients developed ESKD during the study period. There was a 3-year cumulative incidence rate of 1.7% for all patients, a rate of 1.9% for those managed with radical nephrectomy and a rate of 1% for those treated with partial nephrectomy. Other than preoperative kidney disease, the following factors were associated with an increased ESKD risk: age 65 and older; male gender; presurgical diabetes; American Society of Anesthesiologists classification of 3 or higher; socioeconomic disadvantage; and postoperative hospital length of stay of 6 days or more.
“In clinical practice, it is assumed that only patients with clearly perturbed preoperative kidney function or anatomy are at significant risk of ESKD after nephrectomy,” the researchers wrote. “We were able to establish that the potential risk factors for incident ESKD were older age, the presence of diabetes mellitus and socioeconomic disadvantage, which are well known risk factors for CKD in the Australian population and high ASA classification and male sex, both of which are associated with CKD after nephrectomy.” – by Jennifer Byrne
Disclosure s : The researchers report no relevant financial disclosures.