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. 2024 Dec 28;16(12):e76548.
doi: 10.7759/cureus.76548. eCollection 2024 Dec.

Incidence of Proteinuria Post Radical Nephrectomy in Comparison to Partial Nephrectomy: A Comparative Study

Ahmed Alasker  1 , Rakan A Al Muammar  2 , Abdulrahman A Bin Moammar  2 , Hassan Alqahtani  2 , Abdulrahman S Altowaim  2
Affiliations

Incidence of Proteinuria Post Radical Nephrectomy in Comparison to Partial Nephrectomy: A Comparative Study

Ahmed Alasker et al. Cureus. .

Abstract

Objectives The objective of this study is to enhance understanding of the incidence and impact of proteinuria following nephrectomy, to guide clinical decision-making, and to optimize post-operative monitoring strategies. Specifically, the study seeks to compare the incidence of proteinuria in patients undergoing radical nephrectomy and those receiving partial nephrectomy, thereby contributing valuable insights into post-surgical outcomes that could inform treatment approaches and improve patient care. Methods It is a retrospective cohort design, analyzing clinical data from patients who underwent radical or partial nephrectomy in King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, between 2014 and 2022. Data was entered in Excel (Microsoft Corporation, Redmond, Washington, United States) and analyzed in IBM SPSS Statistics for Windows, Version 29.0 (Released 2023; IBM Corp., Armonk, New York, United States). Results There was a total of 310 participants, predominantly male (n=167, 53.9%), with radical nephrectomy (n=188, 60.6%) being more common than partial (n=99, 31.9%). Post surgery, a significant decline in estimated glomerular filtration rate (eGFR) was noted in radical nephrectomy at one to three months (73.09 mL/minute) compared to partial nephrectomy (90.99 mL/minute) (p<0.001), with similar trends at 6-12 months. The mortality rate was low at 1.6% (n=5), with significant associations between preoperative eGFR and mortality (p=0.008). Proteinuria post operation was observed in 27.1% (n=84), with significant differences in proteinuria levels between radical (107.10 mg/dL) and partial nephrectomy (62.80 mg/dL) (p=0.031). Conclusion Our study found that radical nephrectomy was more common and associated with a greater decline in postoperative eGFR compared to partial nephrectomy. Proteinuria was significantly higher in radical nephrectomy patients, and preoperative eGFR was linked to mortality risk, highlighting the need for careful monitoring in high-risk individuals.

Keywords: mortality; nephrectomy; partial nephrectomy; proteinuria; radical nephrectomy.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. King Abdullah International Medical Research Center (KAIMRC) issued approval 0000034024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Different diagnosis among participants (N=310)
RCC: Renal Cell Carcinoma; TCC: Transitional Cell Carcinoma; UPJO: Ureteropelvic Junction Obstruction
Figure 2
Figure 2. Other comorbidities among participants (n=43)
BA: Biliary Atresia, GERD: Gastroesophageal Reflux Disease, SLE: Systemic Lupus Erythematosus, and COPD: Chronic Obstructive Pulmonary Disease
See this image and copyright information in PMC

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