The Incidence And Risk Factors Of Chronic Kidney Disease After Tumor (Radical/Partial) And Simple Nephrectomy - A Retrospective Observational Study.

Introduction : Nephrectomy inevitably reduces the functional renal parenchyma, resulting in loss of renal function[1]. Nephrons decrease with the nephrectomy procedure, and it leads to a decline in eGFR values. eGFR60 is associated with increased cardiovascular events, death, and hospitalization [3,4]. Under these circumstances, it is important for the preservation of renal function not only in healthy subjects but also in populations at risk. Patients who underwent tumor nephrectomy had a higher incidence of CKD compared to patients who underwent simple nephrectomy [1,5,6]. We designed a study to compare the incidence rate of CKD between tumor nephrectomy patients and simple nephrectomy patients and to evaluate predictive factors of CKD. Our objective is to compare the incidence of CKD in patients of radical, partial, and simple nephrectomy. Material And Methods : We retrospectively examined the patients who underwent RN (n-57), PN(n-10), and simple nephrectomy (n-17) between January 2019 to June 2023. All operations are performed by an expert surgeon. Demographic profile age, sex, laterality, comorbidity (hypertension, diabetes), addiction (smoking, alcohol), and preoperative proteinuria were collected. Serum creatinine results within one week, one month, three months, and six months postoperative follow-up were collected. Patients with eGFR above 60 were included in the study. Those who had an abnormal renal function before surgery or were lost to follow-up were excluded. Discussion : Radical nephrectomy is an independent risk factor for the development of CKD, so the preservation of a maximum renal reserve should be pursued in case of partial nephrectomy. Age is a prognostic factor for CKD development. The major reason is that as age increases, nephron atrophy occurs and eGFR decreases. HTN and DM have been identified as predictors of renal impairment in individuals undergoing nephrectomy. Tumour size and preoperative proteinuria are risk factors for CKD development. According to our study, gender, BMI, laterality, and smoking are not prognostic factors for CKD. Conclusion : Age, Co-morbidity, pre-operative proteinuria, type of surgery, immediate postoperative eGFR value, and tumor size are useful predictors of developing CKD after surgery. Therefore, More attention should be given to patients with decreased renal function during postoperative follow-up. PN should be strongly considered for the prevention of postoperative CKD.