Chronic kidney disease risk is increased among patients with renal cell carcinoma, particularly for those with preexisting chronic kidney disease (including proteinuria) but also for those with comorbidities such as diabetes mellitus, hypertension, and obesity. Among those with small renal masses without complex disease, partial nephrectomy should be prioritized given favorable pathologic prognosis and mortality related to cardiovascular disease or chronic kidney disease. Nephrologists should actively participate in a multidisciplinary team to help formulate individualized treatment which will help preserve residual kidney function where possible.
SiegelRLMillerKDJemalA.Cancer statistics, 2018. CA Cancer J Clin2018; 68(1): 7–30.
2.
PatardJJShvartsOLamJSet al. Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urol2004; 171(6Pt1): 2181–2185, quiz 2435.
3.
ChowWDevesaSSWarrenJLet al. Rising incidence of renal cell cancer in the united states. JAMA1999; 281(17): 1628–1631.
4.
KaneCJMallinKRitcheyJet al. Renal cell cancer stage migration: analysis of the National Cancer Data Base. Cancer2008; 113(1): 78–83.
5.
PichlerMHuttererGCChromeckiTFet al. Trends of stage, grade, histology and tumour necrosis in renal cell carcinoma in a European centre surgical series from 1984 to 2010. J Clin Pathol2012; 65(8): 721–724.
6.
HollingsworthJMMillerDCDaignaultSet al. Five-year survival after surgical treatment for kidney cancer: a population-based competing risk analysis. Cancer2007; 109(9): 1763–1768.
7.
Van PoppelHDa PozzoLAlbrechtWet al. 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. J Urol2011; 59(4): 543–552.
8.
WeightCJLarsonBTFerganyAFet al. Nephrectomy induced chronic renal insufficiency is associated with increased risk of cardiovascular death and death from any cause in patients with localized cT1b renal masses. J Urol2010; 184(4): 1317–1323.
9.
HerrHW.A history of partial nephrectomy for renal tumors. J Urol2005; 173(3): 705–708.
10.
PoletajewSAntoniewiczAABorowkaA.Kidney removal the past, presence, and perspectives. Urol J2010; 7(4): 215–223.
11.
BjurlinMAWalterDTakslerGBet al. National trends in the utilization of partial nephrectomy before and after the establishment of AUA guidelines for the management of renal masses. Urology2013; 82(6): 1283–1289.
12.
PierorazioPMJohnsonMHPatelHDet al. Management of renal masses and localized renal cancer: systematic review and meta-analysis. J Urol2016; 196(4): 989–999.
13.
HuSLChangAPerazellaMAet al. The nephrologist’s tumor: basic biology and management of renal cell carcinoma. J Am Soc Nephrol2016; 27(8): 2227–2237.
14.
KimSPMuradMHThompsonRHet al. Comparative effectiveness for survival and renal function of partial and radical nephrectomy for localized renal tumors: a systematic review and meta-analysis. J Urol2012; 188(1): 51–57.
15.
PatelHDKatesMPierorazioPMet al. Balancing cardiovascular (CV) and cancer death among patients with small renal masses: modification by CV risk. BJU Int2015; 115(1): 58–64.
16.
KutikovAEglestonBLCanterDet al. Competing risks of death in patients with localized renal cell carcinoma: a comorbidity based model. J Urol2012; 188(6): 2077–2083.
17.
ChowW-HDongLMDevesaSS.Epidemiology and risk factors for kidney cancer. Nat Rev Urol2010; 7(5): 245–257.
18.
CohenHTMcGovernFJ.Renal-cell carcinoma. N Engl J Med2005; 353(23): 2477–2490.
19.
DentonMDMageeCCOvuworieCet al. Prevalence of renal cell carcinoma in patients with ESRD pre-transplantation: a pathologic analysis. Kidney Int2002; 61(6): 2201–2209.
20.
LowranceWTOrdonezJUdaltsovaNet al. CKD and the risk of incident cancer. J Am Soc Nephrol2014; 25(10): 2327–2334.
21.
BarlowLJKoretsRLaudanoMet al. Predicting renal functional outcomes after surgery for renal cortical tumours: a multifactorial analysis. BJU Int2010; 106(4): 489–492.
22.
JeonHGJeongIGLeeJWet al. Prognostic factors for chronic kidney disease after curative surgery in patients with small renal tumors. Urology2009; 74(5): 1064–1068.
23.
ChoiYSParkYHKimYJet al. Predictive factors for the development of chronic renal insufficiency after renal surgery: a multicenter study. Int Urol Nephrol2014; 46(4): 681–686.
24.
TakagiTKondoTIizukaJet al. Postoperative renal function after partial nephrectomy for renal cell carcinoma in patients with pre-existing chronic kidney disease: a comparison with radical nephrectomy. Int J Urol2011; 18(6): 472–476.
25.
ClarkMAShikanovSRamanJDet al. Chronic kidney disease before and after partial nephrectomy. J Urol2011; 185(1): 43–48.
26.
KimSHLeeSEHongSKet al. Incidence and risk factors of chronic kidney disease in Korean patients with t1a renal cell carcinoma before and after radical or partial nephrectomy. Jpn J Clin Oncol2013; 43(12): 1243–1248.
27.
HungPHTsaiHBHungKYet al. Increased risk of end-stage renal disease in patients with renal cell carcinoma: a 12-year nationwide follow-up study. Medicine (Baltimore)2014; 93(8): e52.
28.
JeonHGChooSHSungHHet al. Small tumour size is associated with new-onset chronic kidney disease after radical nephrectomy in patients with renal cell carcinoma. Eur J Cancer2014; 50(1): 64–69.
29.
ChoALeeJEKwonG-Yet al. Post-operative acute kidney injury in patients with renal cell carcinoma is a potent risk factor for new-onset chronic kidney disease after radical nephrectomy. Nephrol Dial Transplant2011; 26(11): 3496–3501.
30.
SongCBangJKParkHKet al. Factors influencing renal function reduction after partial nephrectomy. J Urol2009; 181(1): 48–53, discussion 53–54.
31.
LaneBRCampbellSCDemirjianSet al. Surgically induced chronic kidney disease may be associated with a lower risk of progression and mortality than medical chronic kidney disease. J Urol2013; 189(5): 1649–1655.
32.
LaneBRDemirjianSDerweeshIHet al. Survival and functional stability in chronic kidney disease due to surgical removal of nephrons: importance of the new baseline glomerular filtration rate. Eur Urol2015; 68(6): 996–1003.
33.
McKiernanJYossepowitchOKattanMWet al. Partial nephrectomy for renal cortical tumors: pathologic findings and impact on outcome. Urology2002; 60(6): 1003–1009.
34.
KutikovAFossettLKRamchandaniPet al. Incidence of benign pathologic findings at partial nephrectomy for solitary renal mass presumed to be renal cell carcinoma on preoperative imaging. Urology2006; 68(4): 737–740.
35.
VolpeAFinelliAGillISet al. Rationale for percutaneous biopsy and histologic characterisation of renal tumours. Eur Urol2012; 62(3): 491–504.
36.
VolpeAMattarKFinelliAet al. Contemporary results of percutaneous biopsy of 100 small renal masses: a single center experience. J Urol2008; 180(6): 2333–2337.
37.
NazimSMAtherMHHafeezKet al. Accuracy of multidetector CT scans in staging of renal carcinoma. Int J Surg2011; 9(1): 86–90.
38.
LeveridgeMJBostromPJKoulourisGet al. Imaging renal cell carcinoma with ultrasonography, CT and MRI. Nat Rev Urol2010; 7(6): 311–325.
39.
SchlomerBFigenshauRSYanYet al. How does the radiographic size of a renal mass compare with the pathologic size. Urology2006; 68(2): 292–295.
LohseCMGuptaSChevilleJC.Outcome prediction for patients with renal cell carcinoma. Semin Diagn Pathol2015; 32(2): 172–183.
42.
O’DonnellKTourojmanMTobertCMet al. Proteinuria is a predictor of renal functional decline in patients with kidney cancer. J Urol2016; 196(3): 658–663.
43.
ThadhaniRPascualMBonventreJV.Acute renal failure. N Engl J Med1996; 334(22): 1448–1460.
44.
SankinASfakianosJPSchiffJet al. Assessing renal function after partial nephrectomy using renal nuclear scintigraphy and estimated glomerular filtration rate. Urology2012; 80(2): 343–346.
45.
CampbellSUzzoRGAllafMEet al. Renal mass and localized renal cancer: AUA guideline. J Urol2017; 198(3): 520–529.
46.
MirMCCapitanioUBertoloRet al. Role of active surveillance for localized small renal masses. Eur Urol Oncol2018; 1(3): 177–187.
47.
PatelHDPierorazioPMJohnsonMHet al. Renal functional outcomes after surgery, ablation, and active surveillance of localized renal tumors: a systematic review and meta-analysis. Clin J Am Soc Nephrol2017; 12(7): 1057–1069.
48.
ScosyrevEMessingEMSylvesterRet al. Renal function after nephron-sparing surgery versus radical nephrectomy: results from EORTC randomized trial 30904. Eur Urol2014; 65(2): 372–377.
49.
JhaveriKDWanchooRSakhiyaVet al. Adverse renal effects of novel molecular oncologic targeted therapies: a narrative review. Kidney Int Rep2017; 2(1): 108–123.
50.
IsharwalSYeWWangAet al. Impact of comorbidities on functional recovery from partial nephrectomy. J Urol2018; 199(6): 1433–1439.
51.
BrewerKO’MalleyRLHaynMet al. Perioperative and renal function outcomes of minimally invasive partial nephrectomy for T1b and T2a kidney tumors. J Endourol2012; 26(3): 244–248.
52.
MariusdottirEJonssonEMarteinssonVTet al. Kidney function following partial or radical nephrectomy for renal cell carcinoma: a population-based study. Scand J Urol2013; 47(6): 476–482.
53.
MiyamotoKInoueSKajiwaraMet al. Comparison of renal function after partial nephrectomy and radical nephrectomy for renal cell carcinoma. Urol Int2012; 89(2): 227–232.
54.
RoosFCBrennerWThomasCet al. Functional analysis of elective nephron-sparing surgery vs radical nephrectomy for renal tumors larger than 4 cm. Urology2012; 79(3): 607–613.
55.
SunMBianchiMHansenJet al. Chronic kidney disease after nephrectomy in patients with small renal masses: a retrospective observational analysis. Eur Urol2012; 62(4): 696–703.
56.
YasudaYYuasaTYamamotoSet al. Evaluation of the RENAL nephrometry scoring system in adopting nephron-sparing surgery for cT1 renal cancer. Urol Int2013; 90(2): 179–183.
57.
KaushikDKimSPChildsMAet al. Overall survival and development of stage IV chronic kidney disease in patients undergoing partial and radical nephrectomy for benign renal tumors. Eur Urol2013; 64(4): 600–606.
58.
KimCSBaeEHMaSKet al. Impact of partial nephrectomy on kidney function in patients with renal cell carcinoma. BMC Nephrol2014; 15: 181.
59.
TakagiTMirMCSharmaNet al. Compensatory hypertrophy after partial and radical nephrectomy in adults. J Urol2014; 192(6): 1612–1618.
60.
WolduSLWeinbergACKoretsRet al. Who really benefits from nephron-sparing surgery. Urology2014; 84(4): 860–867.
61.
KyungYSYouDKwonTet al. The type of nephrectomy has little effect on overall survival or cardiac events in patients of 70 years and older with localized clinical t1 stage renal masses. Korean J Urol2014; 55(7): 446–452.
62.
ChungJSSonNHLeeSEet al. Overall survival and renal function after partial and radical nephrectomy among older patients with localised renal cell carcinoma: a propensity-matched multicentre study. Eur J Cancer2015; 51(4): 489–497.
63.
DanzigMRGhandourRAChangPet al. Active surveillance is superior to radical nephrectomy and equivalent to partial nephrectomy for preserving renal function in patients with small renal masses: results from the DISSRM registry. J Urol2015; 194(4): 903–909.
64.
LeppertJTLambertsRWThomasICet al. Incident CKD after radical or partial nephrectomy. J Am Soc Nephrol2018; 29(1): 207–216.
65.
EllisRJEdeyDPDelVecchioSJet al. End-stage kidney disease following surgical management of kidney cancer. Clin J Am Soc Nephrol2018; 13(11): 1641–1648.
66.
GershmanBThompsonRHBoorjianSAet al. Radical versus partial nephrectomy for cT1 renal cell carcinoma. Eur Urol2018; 74(6): 825–832.
67.
LauWKBluteMLWeaverALet al. Matched comparison of radical nephrectomy vs nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Mayo Clin Proc2000; 75(12): 1236–1242.
68.
McKiernanJSimmonsRKatzJet al. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology2002; 59(6): 816–820.
69.
KlarenbachSMooreRBChapmanDWet al. Adverse renal outcomes in subjects undergoing nephrectomy for renal tumors: a population-based analysis. Eur Urol2011; 59(3): 333–339.
70.
SuerEBurguBGokceMIet al. Comparison of radical and partial nephrectomy in terms of renal function: a retrospective cohort study. Scand J Urol Nephrol2011; 45(1): 24–29.
71.
YapSAFinelliAUrbachDRet al. Partial nephrectomy for the treatment of renal cell carcinoma (RCC) and the risk of end-stage renal disease (ESRD). BJU Int2015; 115: 897–906.
WuJSuk-OuichaiCDongWet al. Analysis of survival for patients with chronic kidney disease primarily related to renal cancer surgery. BJU Int2018; 121(1): 93–100.
74.
HenriksenKJMeehanSMChangA.Nonneoplastic kidney diseases in adult tumor nephrectomy and nephroureterectomy specimens: common, harmful, yet underappreciated. Arch Pathol Lab Med2009; 133(7): 1012–1025.
75.
BonsibSMPeiY.The non-neoplastic kidney in tumor nephrectomy specimens: what can it show and what is important. Adv Anat Pathol2010; 17(4): 235–250.
76.
AlgabaFDelahuntBBerneyDMet al. Handling and reporting of nephrectomy specimens for adult renal tumours: a survey by the European Network of Uropathology. J Clin Pathol2012; 65(2): 106–113.
77.
MerrillSB.Postoperative surveillance for renal cell carcinoma. Urol Clin North Am2017; 44(2): 313–323.
FinelliAIsmailaNBroBet al. Management of small renal masses: American society of clinical oncology clinical practice guideline. J Clin Oncol2017; 35(6): 668–680.
