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

Research output: Contribution to journalArticle

7 Citations (Scopus)

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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Cryosurgery
Nephrectomy
Propensity Score
Kidney
Glomerular Filtration Rate
Chronic Renal Insufficiency
Disease Progression
Epidemiology

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., ... 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

Renal functional outcomes in patients undergoing percutaneous cryoablation or partial nephrectomy for a solitary renal mass. / Mason, Ross J.; Atwell, Thomas D.; Lohse, Christine; Bhindi, Bimal; Weisbrod, Adam; Boorjian, Stephen A.; Leibovich, Bradley C.; Schmit, Grant D.; Thompson, R. Houston.

In: BJU International, 2017.

Research output: Contribution to journalArticle

Mason, RJ, Atwell, TD, Lohse, C, Bhindi, B, Weisbrod, A, Boorjian, SA, Leibovich, BC, Schmit, GD & Thompson, RH 2017, '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
Mason, Ross J. ; Atwell, Thomas D. ; Lohse, Christine ; Bhindi, Bimal ; Weisbrod, Adam ; Boorjian, Stephen A. ; Leibovich, Bradley C. ; Schmit, Grant D. ; Thompson, R. Houston. / Renal functional outcomes in patients undergoing percutaneous cryoablation or partial nephrectomy for a solitary renal mass. In: BJU International. 2017.
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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.",
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AU - Mason, Ross J.

AU - Atwell, Thomas D.

AU - Lohse, Christine

AU - Bhindi, Bimal

AU - Weisbrod, Adam

AU - Boorjian, Stephen A.

AU - Leibovich, Bradley C.

AU - Schmit, Grant D.

AU - Thompson, R. Houston

PY - 2017

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N2 - 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.

AB - 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.

KW - Cryoablation

KW - Kidney neoplasms

KW - Partial nephrectomy

KW - Renal cell carcinoma

KW - Renal function

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