Early pre-operative and prolonged post-operative nephrological consultation might prevent the worsening of renal impairment in renal cancer patient candidates to nephrectomy

10^th European Nephrology Conference

October 24-26, 2016 Rome, Italy

Cosmai Laura, Liguigli Wanda, Porta Camillo, Gallieni Maurizio, Foramitti Marina and Malberti Fabio

Istituti Ospitalieri di Cremona, Italy
IRCCS San Matteo University Hospital Foundation, Italy
San Carlo Borromeo Hospital, Italy
Joint Italian Societies of Nephrology and Medical Oncology, Italy

Posters & Accepted Abstracts: J Nephrol Ther

Abstract :

Background: Partial nephrectomy (PN) is recommended as the preferred surgical option in organ confined renal tumors measuring up to 7 cm, whilst radical nephrectomy (RN) is the preferred option for tumors of more than 7 cm; RN is also recommended if PN is not technically feasible. RN in particular may affect renal function, especially in patients (pts.) with pre-existing chronic kidney disease (CKD). Patients & Methods: From December 2012 to January 2015, 97 pts. candidates to RN were referred to our Ambulatory of Onco- Nephrology; of these pts., 21 had a pre-existing stage III to V CKD. Nephrological consultation was performed before surgery, immediately post-surgery, and then every 3 months for the first 3 years post-RN. Primary endpoint of this single-arm, prospective, pilot study was the percentage of pts. who developed some worsening of kidney function over the 3-years follow-up. Interventions during Nephrological consultations included management of co-morbidities and risk factors (e.g. hypertension, diabetes, etc.), prevention of further renal damage from potentially nephrotoxic drugs (e.g. NSAIDs) and protocols of hydration before contrast medium administration for routine oncological follow-up. Results: Immediately post-RN, 46 pts. presented a reduction in eGFR (9 within the group with pre-existing CKD, and 37 in the group without known renal impairment). Of these 46 pts., at 3-months post-RN, 30 recovered to their pre-nephrectomy renal function, while the remaining 16 did not show any further decrease in eGFR. Only 5 pts. (out of 97) were lost at follow-up during the 3 years subsequent to RN. Of the 92 pts., who reached the 3 year post-RN mark, just 2 showed a decline in eGFR. Conclusions: An early and prolonged nephrological consultation in cancer pts. Candidates to RN might prevent kidney impairment.

Biography :

Email: lacos@iol.it