Renal functional outcomes in patients undergoing percutaneous cryoablation or partial nephrectomy for a solitary renal mass

Ross J. Mason, Thomas D. Atwell, Christine Lohse, Bimal Bhindi, Adam Weisbrod, Stephen A. Boorjian, Bradley C. Leibovich, Grant D. Schmit, R. Houston Thompson

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Abstract

Objectives: To compare renal functional changes after percutaneous cryoablation (PCA) or partial nephrectomy (PN). Patients and Methods: Patients who underwent PCA or PN for a solitary renal mass at a single institution were identified (2003-2013). Estimated glomerular filtration rates (eGFRs) were calculated at baseline, discharge, and at the 3-month follow-up using the Chronic Kidney Disease Epidemiology Collaboration equation. Changes in renal function were compared between groups using 1:1 propensity score (PS) matching, adjustment for PS quintile, and inverse probability weighting (IPW). Results: There were 2 040 procedures available for the PS analyses, including 448 PCA and 1 592 PN. After PS adjustments, there were no significant differences in baseline clinical features between PCA and PN patients. In the PS-matched analysis, the change in eGFR from baseline to discharge for PCA and PN patients was -3.1 and -1.1 mL/min/1.73 m2, respectively (P = 0.038), with percentage changes of -4.5% and 0% respectively (P = 0.006). From baseline to the 3-month follow-up, the absolute change in eGFR for PCA and PN patients was -4.3 and -2.1 mL/min/1.73 m2, respectively (P = 0.008), and the percentage change was -6.1% and -2.4% respectively (P = 0.005). Similar results were obtained after adjusting for PS quintiles and in the IPW analysis. Importantly, the rate of chronic kidney disease stage progression at the 3-month follow-up was similar between the groups (21% vs 18%). Conclusions: Our results confirm that both PCA and PN have a minor impact on renal function. While we observed a statistically greater decline in eGFR after PCA compared with PN, both approaches result in excellent preservation of renal function.

Original languageEnglish (US)
JournalBJU International
DOIs
StateAccepted/In press - 2017

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Keywords

  • Cryoablation
  • Kidney neoplasms
  • Partial nephrectomy
  • Renal cell carcinoma
  • Renal function

ASJC Scopus subject areas

  • Urology

Cite this

Mason, R. J., Atwell, T. D., Lohse, C., Bhindi, B., Weisbrod, A., Boorjian, S. A., Leibovich, B. C., Schmit, G. D., & Thompson, R. H. (Accepted/In press). Renal functional outcomes in patients undergoing percutaneous cryoablation or partial nephrectomy for a solitary renal mass. BJU International. https://doi.org/10.1111/bju.13917