CHANGES OF RENAL FUNCTION AFTER RADICAL NEPHRECTOMY IN RENAL CELL CARCINOMA PATIENTS

초록

Radical nephrectomy (RN) has been known as gold standard treatment for localized renal cell carcinoma (RCC). However, recent studies suggested RN as a significant risk factor of chronic kidney disease (CKD) in RCC patients. This study was performed to evaluate the glomerular filtration rate (GFR) changes and the factors affecting GFR changes 1 year after RN in RCC patients.We retrospectively reviewed the record of 187 patients who underwent RN between 1996 and 2006. Exclusion criteria were patients with metastatic cancer or cancer of other sites, pre-RN GFR of less than 60ml/min/1.73m2, age of less than 18, inadequate data ( absence of exam, F/U loss, death), post operative complications ( acute renal failure, sepsis, hemodynamic instability), and patients who received chemotherapy. Finally, 62 patients were enrolled. We calculated GFR changes between pre-RN and 1 year after RN. GFR was estimated by MDRD(non-IDMS-creatinine) equation. In RCC patients, GFR was significantly decreased and CKD stage 3 was highly developed 1 year after RN. The factors affecting GFR changes after RN in RCC patients were pre-op GFR and hypertension.