Long-term assessment of renal hnction following nephrectomy for stage

Objective To evaluate the impact of nephrectomy on renal function in people who are potential candidates for nephron sparing surgery, i.e. partial nephrectomy. Patients and methods A retrospective analysis was carried out of 109 patients (35 women, 74 men) who had undergone a nephrectomy for stage I renal carcinoma at the University of Michigan between 1960 and 1979. All patients had a functioning contralateral kidney and had undergone at least one post-operative serum creatinine evaluation. Statistical analysis was by Pearson’s correlation coefficient. Results One individual developed a transitional cell carcinoma in the remaining renal pelvis and was treated with nephroureterectomy. No other patient progressed to dialysis. Five patients had post-operative serum creatinine levels from 22 1 to 3 54 pmol/l, one of whom had undergone both a nephrectomy and a partial nephrectomy for bilateral renal tumours. The remaining four had renal disease including diabetes, hypertension, pyelonephritis and renal artery stenosis. There was a strong association between pre-operative and post-operative serum creatinine values. Conclusion Patients with low stage renal tumours and a normal contralateral kidney are at low risk of progression to renal failure.