Deterioration in the renal function and risk of microalbuminuria after radical, simple and donor nephrectomy: A long-term outcome

Abstract

Objectives: Evaluation of deterioration in renal function and risk of micro albuminuria after radical, simple and donor nephrectomy.

Materials and methods: A total of 594 patients underwent nephrectomy (159 radical, 318 simple and 117 donors) from February 2009 to December 2012 in our institute. First 300 eligible patients were divided in 3 groups, each having equalled number of patients. Group 1 was consisted of patients who underwent radical, group 2 had simple and group 3 had donor nephrectomy. These patients were followed up to February 2015. Follow up of all the patients were done at first month following the surgery and then in every six months subsequently. The follow up included the measurement of serum creatinine and urinary micro albumin in a spot urine sample. CKD-EPI equation was used for calculation of e GFR.

Results: At the end of our study, 35 patients (41.6%) in group 1 and 8 patients (8.69%) in group 2 developed CKD stage 3. During the follow-up period, 41% patients in group 1, 13% in group 2 and 4% in group 3 developed MA.

Conclusion: Nephron-sparing surgery should be the standard treatment of renal tumors, wherever possible. There should be a regular follow up of the patients after radical, simple and donor nephrectomy because of risk of CKD. Early consultation with nephrologists should be done by the patients who are suffering from MA after nephrectomy.

Keywords: Chronic kidney disease; glomerular filtration rate; micro albuminuria; nephrectomy.

Graph 1

Mean glomerular filtration rate of all the patients in each group according to time since nephrectomy

Graph 2

Mean glomerular filtration rate of the patients suffering from microalbumin in each group according to time since nephrectomy (significant fall P < 0.001)