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    Korean J Urol. 2007 Dec;48(12):1213-1218. Korean.
    Published online Dec 31, 2007.
    https://doi.org/10.4111/kju.2007.48.12.1213
    Copyright © 2007 The Korean Urological Association
    Original Article

    Renal Function after Partial Nephrectomy for Renal Cell Carcinoma in Solitary Kidney

    Yun Hyung Jang, Hanjong Ahn,1 and Choung-Soo Kim1
      • Department of Urology, National Police Hospital, Seoul, Korea.
      • 1Department of Urology, University of Ulsan College of Medicine, Seoul, Korea.
    • Corresponding author (Email: cskim@amc.seoul.kr )
    Received June 11, 2007; Accepted October 23, 2007.

    Abstract

    Purpose

    Renal cell carcinoma (RCC) in solitary kidney is an absolute indication for partial nephrectomy. We evaluated the renal function after partial nephrectomy for renal cell carcinoma in a solitary kidney.

    Materials and Methods

    Partial nephrectomy was performed in 14 patients with localized sporadic RCCs that developed in a solitary kidney between January 1993 and December 2005. In 8 patients (57%), the contralateral kidney had been surgically removed. In the remaining 6 patients, 4 had a contralateral nonfunctioning kidney (29%) and 2 had nephrolithiasis (14%). Three patients were treated with enucleation, and partial nephrectomy was done in 11 patients. The recorded variables we studied were the preoperative and postoperative serum creatinine levels, whether renal ischemia and hypothermia was used, the duration of renal ischemia and the percent of renal parenchyma that was resected.

    Results

    At mean follow-up of 55.6 months (range: 16.3-106.6), the mean serum creatinine had increased from 1.03mg/dl preoperatively to 1.26 mg/dl postoperatively (p>0.05). The mean serum creatinine had significantly increased at 3, 6 and 12 months after surgery (p<0.05). The postoperative serum creatinine after 16 months was still increased compared to the preoperative serum creatinine, but there was no statistical significance (p>0.05). None of the 14 patients required dialysis for end stage renal disease after surgery. The normal preoperative serum creatinine had increased above 1.5mg/dl in two patients, but not above 2.0mg/dl. One patient had multiple renal cell carcinoma masses and one had diabetes mellitus. The postoperative creatinine of the 9 patients who had renal warm ischemia was not significantly different from the 5 patients who had no ischemia (p>0.05). The renal ischemia time, cold ischemia and the resected percent volume of the renal parenchyma were found to have no statistically significant impact on postoperative renal function (p>0.05).

    Conclusions

    Partial nephrectomy safely preserves renal function in patients with solitary kidney.

    Keywords
    Kidney; Nephrectomy; Carcinoma; Abnormalities

    Figures

    Fig. 1
    Changes of creatinine before and after partial nephrectomy.

    Tables

    Table 1
    Clinical and pathological characteristics of the patients

    Table 2
    Preoperative creatinine level and the postoperative level after 16 months follow-up

    Table 3
    Comparison of postoperative creatinine according to the intraoperative factors

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    MeSH Terms
    Carcinoma, Renal Cell*
    Cold Ischemia
    Creatinine
    Diabetes Mellitus
    Dialysis
    Follow-Up Studies
    Humans
    Hypothermia
    Ischemia
    Kidney Failure, Chronic
    Kidney*
    Nephrectomy*
    Nephrolithiasis
    Warm Ischemia
    Metrics
    Share
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