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Prevalence of baseline chronic kidney disease in 2,769 Chinese patients with renal cancer: Nephron-sparing treatment is still underutilized

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Abstract

Purpose

To evaluate the prevalence of baseline chronic kidney disease (CKD) in a large cohort of patients with renal masses in a single Chinese institution. Estimated glomerular filtration rate (eGFR) and CKD stage are more clinically relevant to predict the risk of morbidity and mortality in patients after nephrectomy. But, sCr reflects renal function poorly.

Methods

We retrospectively identified patients undergoing kidney surgery between January 2002 and June 2012. eGFR was calculated using the modification of diet in renal disease formulas modified based on Chinese people. CKD stages I–V were defined using the National Kidney Foundation definitions.

Results

A total of 2769 patients had adequate data available to calculate a preoperative eGFR (mL/min/1.73m2) with renal cancer confirmed by pathology. Of all patients, 97.7 % awaiting surgery at our institution had a “normal” baseline sCr (≤1.4 mg/dL), and 3.2 % of patients had CKD stage III or worse. Of the 401 patients ≥70 years old, 16.7 % (67/401) had CKD stage III.

Conclusion

Many patients with a seemingly normal sCr have CKD stage III or worse, especially in patients over 70 years old. Given the high prevalence of baseline CKD in patients with renal cancer, it is important to preserve renal parenchyma when treating them surgically.

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References

  1. Mathew A, Devesa SS, Fraumeni JF Jr, Chow WH (2002) Global increases in kidney cancer incidence, 1973–1992. Eur J Cancer Prev 11:171–178

    Article  CAS  PubMed  Google Scholar 

  2. Chow WH, Devesa SS (2008) Contemporary epidemiology of renal cell cancer. Cancer J 14:288–301

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK (2006) Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst 98:1331–1334

    Article  PubMed  Google Scholar 

  4. Van poppel H, Becker F, Cadeddu JA et al (2011) Treatment of localized renal cell carcinoma. Eur Urol 60(4):662–672

    Article  PubMed  Google Scholar 

  5. Campbell SC, Novick AC, Belldegrun A et al (2009) Guideline for management of the clinical T1 renal mass. J Urol 182(4):1271–1279

    Article  PubMed  Google Scholar 

  6. Zhang C, Li X, Hao H et al (2012) The correlation between size of renal cell carcinoma and its histopathological characteristics: a single center study of 1867 renal cell carcinoma cases. BJU Int. doi:10.1111/j.1464-410X.2012.11173.x

    Google Scholar 

  7. Van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A, Colombel M, Klotz L, Skinner E, Keane T, Marreaud S, Collette S, Sylvester R (2011) A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol 59(4):543–552

    Article  PubMed  Google Scholar 

  8. Lesage K, Joniau S, Fransis K, Van Poppel H (2007) Comparison between open partial and radical nephrectomy for renal tumours: perioperative outcome and health-related quality of life. Eur Urol 51(3):614–620

    Article  PubMed  Google Scholar 

  9. Fergany AF, Hafez KS, Novick AC (2000) Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol 163(2):442–445

    Article  CAS  PubMed  Google Scholar 

  10. Weight CJ, Lythgoe C, Unnikrishnan R, Lane BR, Campbell SC, Fergany AF (2011) Partial nephrectomy does not compromise survival in patients with pathologic upstaging to pT2/pT3 or high-grade renal tumors compared with radical nephrectomy. Urology 77(5):1142–1146

    Article  PubMed  Google Scholar 

  11. Thompson RH, Siddiqui S, Lohse CM, Leibovich BC, Russo P, Blute ML (2009) Partial versus radical nephrectomy for 4 to 7 cm renal cortical tumors. J Urol 182:2601–2606

    Article  PubMed  Google Scholar 

  12. Breau RH, Crispen PL, Jimenez RE, Lohse CM, Blute ML, Leibovich BC (2010) Outcome of stage T2 or greater renal cell cancer treated with partial nephrectomy. J Urol 183(3):903–908

    Article  PubMed  Google Scholar 

  13. Touijer K, Jacqmin D, Kavoussi LR, Montorsi F, Patard JJ, Rogers CG, Russo P, Uzzo RG, Van Poppel H (2012) The expanding role of partial nephrectomy: a critical analysis of indications, results, and complications. Eur Urol 57(2):214–222

    Article  Google Scholar 

  14. Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y, Xu JS, Huang SM, Wang LN, Huang W, Wang M, Xu GB, Wang HY (2006) Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol 17:2937–2944

    Article  PubMed  Google Scholar 

  15. National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266

    Google Scholar 

  16. Perrone RD, Steinman TI, Beck GJ, Skibinski CI, Royal HD, Lawlor M, Hunsicker LG (1990) Utility of radioisotopic filtration markers in chronic renal insufficiency: simultaneous comparison of 125I-iothalamate, 169Yb-DTPA, 99mTc-DTPA, and inulin. The modification of diet in renal disease study. Am J Kidney Dis 16(3):224–235

    Article  CAS  PubMed  Google Scholar 

  17. Kurella Tamura M, Anand S, Li S, Chen SC, Whaley-Connell AT, Stevens LA, Norris KC (2011) Comparison of CKD awareness in a screening population using the modification of diet in renal disease (MDRD) study and CKD epidemiology collaboration (CKD-EPI) equations. Am J Kidney Dis 57(3 Suppl 2):S17–S23

    Article  PubMed  Google Scholar 

  18. Zhang L, Wang F, Wang L, Wang W, Liu B, Liu J, Chen M, He Q, Liao Y, Yu X, Chen N, Zhang JE, Hu Z, Liu F, Hong D, Ma L, Liu H, Zhou X, Chen J, Pan L, Chen W, Wang W, Li X, Wang H (2012) Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet 379(9818):815–822

    Article  PubMed  Google Scholar 

  19. McCullough PA, Li S, Jurkovitz CT et al (2008) CKD and cardiovascular disease in screened high-risk volunteer and general populations: the Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES) 1999-2004. Am J Kidney Dis 51(4 Suppl 2):S38–S45

    Article  PubMed  Google Scholar 

  20. Nitsch D, Nonyane BA, Smeeth L et al (2011) CKD and Hospitalization in the Elderly: a community-based cohort study in the United Kingdom. Am J Kidney Dis 57(5):664–672

    Article  PubMed Central  PubMed  Google Scholar 

  21. Roderick PJ, Atkins RJ, Smeeth L et al (2009) CKD and mortality risk in older people: a community-based population study in the United Kingdom. Am J Kidney Dis 53(6):950–960

    Article  PubMed  Google Scholar 

  22. Keith DS, Nichols GA, Gullion CM et al (2004) Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 164(6):659–663

    Article  PubMed  Google Scholar 

  23. Tan L, Tai BC, Wu F, Raman L et al (2011) Impact of kidney disease outcomes quality initiative guidelines on the prevalence of chronic kidney disease after living donor nephrectomy. J Urol 185(5):1820–1825

    Article  PubMed  Google Scholar 

  24. Sun M, Bianchi M, Hansen J et al (2012) Chronic kidney disease after nephrectomy in patients with small renal masses: a retrospective observational analysis. Eur Urol 62(4):696–703

    Article  PubMed  Google Scholar 

  25. Yokoyama Minato, Fujii Yasuhisa, Iimura Yasumasa et al (2011) Longitudinal change in renal function after radical nephrectomy in Japanese patients with renal cortical tumors. J Urol 185:2066–2071

    Article  PubMed  Google Scholar 

  26. Patel AR, Eggener SE (2011) Warm ischemia less than 30 min is not necessarily safe during partial nephrectomy: every minute matters. Urol Oncol 29:826–828

    Article  PubMed  Google Scholar 

  27. Porpiglia F, Renard J, Billia M, Musso F, Volpe A, Burruni R, Terrone C, Colla L, Piccoli G, Podio V, Scarpa RM (2007) Renal warm ischemia over 30 min during laparoscopic partial nephrectomy possible? 1-year results of a prospective study. Eur Urol 52:1170–1178

    Article  PubMed  Google Scholar 

  28. Ng CK, Gill IS, Patil MB, Hung AJ, Berger AK, de Castro Abreu AL, Nakamoto M, Eisenberg MS, Ukimura O, Thangathurai D, Aron M, Desai MM (2012) Anatomic renal artery branch microdissection to facilitate zero-ischemia partial nephrectomy. Eur Urol 61:67–74

    Article  PubMed  Google Scholar 

  29. Lane BR, Abouassaly R, Gao T et al (2010) Active treatment of localized renal tumors may not impact overall survival in patients aged 75 years or older. Cancer 116(13):3119–3126

    Article  PubMed  Google Scholar 

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Conflict of interest

None of the contributing authors have any conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript.

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Authors and Affiliations

  1. Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China

    Kai-wei Yang, Geng-yan Xiong, Xue-song Li, Yuan Tang, Qi Tang, Cui-jian Zhang, Zhi-song He & Li-qun Zhou

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  1. Kai-wei Yang
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  2. Geng-yan Xiong
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  4. Yuan Tang
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Correspondence to Xue-song Li or Li-qun Zhou.

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Yang, Kw., Xiong, Gy., Li, Xs. et al. Prevalence of baseline chronic kidney disease in 2,769 Chinese patients with renal cancer: Nephron-sparing treatment is still underutilized. World J Urol 32, 1027–1031 (2014). https://doi.org/10.1007/s00345-013-1178-0

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  • DOI: https://doi.org/10.1007/s00345-013-1178-0

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