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Current Urology Reports
Erschienen in: Current Urology Reports 1/2016

01.01.2016 | Kidney Diseases (G Ciancio, Section Editor)

Renal Function Following Nephron Sparing Procedures: Simply a Matter of Volume?

verfasst von: Michael J. Biles, G. Joel DeCastro, Solomon L. Woldu

Erschienen in: Current Urology Reports | Ausgabe 1/2016

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Abstract

Partial nephrectomy (PN) is the current standard of care for the management of small renal masses (SRM), providing comparable oncologic control with improved renal functional outcomes. Additionally, new technologies such as thermal ablation provide attractive alternatives to traditional extirpative surgery. The obvious benefit of these nephron sparing procedures (NSPs) is to the preservation of renal parenchymal volume (RPV), but the factors that influence postoperative renal function are complex and inter-related, and include non-modifiable factors such as baseline renal function and tumor size, complexity, and location as well as potentially modifiable factors such as ischemia time, ischemia type, and RPV preservation. Our review presents the most recent evidence analyzing the relationship between the modifiable factors in PN and renal outcomes, with a focus on RPV preservation. Furthermore, novel surgical techniques, imaging modalities, and NSPs are discussed, evaluating their efficacy in maximizing functional nephron mass and improving long-term renal outcomes.
Literatur
1.
Campbell SC, Novick AC, Belldegrun A, et al. Guideline for management of the clinical T1 renal mass. J Urol. 2009;182:1271–9.PubMedCrossRef
2.
Huang WC, Levey AS, Serio AM, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006;7:735–40.PubMedPubMedCentralCrossRef
3.
Van Poppel H, Da Pozzo L, Albrecht W, et 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. Eur Urol. 2011;59:543–52.PubMedCrossRef
4.
Sammon JD, Karakiewicz PI, Sun M, et al. Robot-assisted vs. laparoscopic partial nephrectomy: utilization rates and perioperative outcomes. Int Braz J Urol. 2013;39:377–86.PubMedCrossRef
5.
El Dib R, Touma NJ, Kapoor A. Cryoablation vs radiofrequency ablation for the treatment of renal cell carcinoma: a meta-analysis of case series studies. BJU Int. 2012;110:510–6.PubMedCrossRef
6.
Swaminath A, Chu W. Stereotactic body radiotherapy for the treatment of medically inoperable primary renal cell carcinoma: current evidence and future directions. Can Urol Assoc J. 2015;9:275–80.PubMedPubMedCentralCrossRef
7.
Sarnak MJ, Levey AS, Schoolwerth AC, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension. 2003;42:1050–65.PubMedCrossRef
8.
Fried LF, Katz R, Sarnak MJ, et al. Kidney function as a predictor of noncardiovascular mortality. J Am Soc Nephrol. 2005;16:3728–35.PubMedCrossRef
9.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305.PubMedCrossRef
10.••
Mir MC, Campbell RA, Sharma N, et al. Parenchymal volume preservation and ischemia during partial nephrectomy: functional and volumetric analysis. Urology. 2013;82:263–8. Retrospective review of patients who underwent partial nephrectomy for a small renal mass to evaluate factors associated with ultimate post-operative renal function, and one of the first to include renal parenchymal volume preservation as measured by 3-D volumetric analysis as a factor. The study found that ultimate renal function after partial nephrectomy was most strongly correlated with renal parenchymal volume, while limited warm ischemia or cold ischemia played a secondary role.PubMedCrossRef
11.•
Woldu SL, Thoreson GR, Okhunov Z, et al. Comparison of renal parenchymal volume preservation between partial nephrectomy, cryoablation, and radiofrequency ablation using 3D volume measurements. J Endourol. 2015;29:948–55. Retrospective review of three institutional databases of patients with small renal masses treated by partial nephrectomy, cryoablation, or radiofrequency ablation to determine the influence on nephron sparing procedure choice on renal parenchymal volume loss. The study found that there was no difference between approach to partial nephrectomy (open, laparoscopic, robotic) or modality of thermal ablation (cryoablation vs. radiofrequency ablation), but choice of thermal ablation was independently associated with a decreased renal parenchymal volume loss, independent tumor characteristics as assessed by R.E.N.A.L. nephrometry scoring.PubMedCrossRef
12.
Simmons MN, Fergany AF, Campbell SC. Effect of parenchymal volume preservation on kidney function after partial nephrectomy. J Urol. 2011;186:405–10.PubMedCrossRef
13.
Mibu H, Tanaka N, Hosokawa Y, et al. Estimated functional renal parenchymal volume predicts the split renal function following renal surgery. World J Urol. 2015;33:1571–7.PubMedCrossRef
14.
Simmons MN, Hillyer SP, Lee BH, Fergany AF, Kaouk J, Campbell SC. Functional recovery after partial nephrectomy: effects of volume loss and ischemic injury. J Urol. 2012;187:1667–73.PubMedCrossRef
15.
Scosyrev E, Messing EM, Sylvester R, Campbell S, Van Poppel H. Renal function after nephron-sparing surgery versus radical nephrectomy: results from EORTC randomized trial 30904. Eur Urol. 2014;65:372–7.PubMedCrossRef
16.
17.
Chow WH, Devesa SS, Warren JL, Fraumeni Jr JF. Rising incidence of renal cell cancer in the United States. JAMA. 1999;281:1628–31.PubMedCrossRef
18.
Baillargeon-Gagne S, Jeldres C, Lughezzani G, et al. A comparative population-based analysis of the rate of partial vs radical nephrectomy for clinically localized renal cell carcinoma. BJU Int. 2010;105:359–64.PubMedCrossRef
19.
Campbell SC, Novick AC, Belldegrun A, et al. Guideline for management of the clinical T1 renal mass. J Urol. 2009;182:1271–9.PubMedCrossRef
20.
Woldrich JM, Palazzi K, Stroup SP, et al. Trends in the surgical management of localized renal masses: thermal ablation, partial and radical nephrectomy in the USA, 1998-2008. BJU Int. 2013;111:1261–8.PubMedCrossRef
21.
Staehler M, Bader M, Schlenker B, et al. Single fraction radiosurgery for the treatment of renal tumors. J Urol. 2015;193:771–5.PubMedCrossRef
22.
Fergany AF, Hafez KS, Novick AC. Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urol. 2000;163:442–5.PubMedCrossRef
23.
Lee CT, Katz J, Shi W, Thaler HT, Reuter VE, Russo P. Surgical management of renal tumors 4 cm. or less in a contemporary cohort. J Urol. 2000;163:730–6.PubMedCrossRef
24.
Lane BR, Campbell SC, Demirjian S, Fergany AF. Surgically induced chronic kidney disease may be associated with a lower risk of progression and mortality than medical chronic kidney disease. J Urol. 2013;189:1649–55.PubMedCrossRef
25.
Samuel D, Angarita B, Igboeli B, Woldu H. Four international residents’ perspectives on working overseas as part of residency training: Liberia, Myanmar, and Saint Vincent/Grenadines. Ann Glob Health. 2014;80:143–5.PubMedCrossRef
26.
27.
Krohn AG, Ogden DA, Holmes JH. Renal function in 29 healthy adults before and after nephrectomy. JAMA. 1966;196:322–4.PubMedCrossRef
28.
Chen Z, Fang J, Li G, et al. Compensatory changes in the retained kidney after nephrectomy in a living related donor. Transplant Proc. 2012;44:2901–5.PubMedCrossRef
29.
Woldu SL, Weinberg AC, Korets R, et al. Who really benefits from nephron-sparing surgery? Urology. 2014;84:860–7.PubMedCrossRef
30.
Mir MC, Ercole C, Takagi T, et al. Decline in renal function after partial nephrectomy: etiology and prevention. J Urol. 2015;193:1889–98.PubMedCrossRef
31.
Uzzo RG, Novick AC. Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol. 2001;166:6–18.PubMedCrossRef
32.
Novick AC. Renal hypothermia: in vivo and ex vivo. Urol Clin N Am. 1983;10:637–44.
33.
Funahashi Y, Yoshino Y, Sassa N, Matsukawa Y, Takai S, Gotoh M. Comparison of warm and cold ischemia on renal function after partial nephrectomy. Urology. 2014;84:1408–12.PubMedCrossRef
34.
Marley CS, Siegrist T, Kurta J, et al. Cold intravascular organ perfusion for renal hypothermia during laparoscopic partial nephrectomy. J Urol. 2011;185:2191–5.PubMedCrossRef
35.
Abe T, Sazawa A, Harabayashi T, et al. Renal hypothermia with ice slush in laparoscopic partial nephrectomy: the outcome of renal function. J Endourol. 2012;26:1483–8.PubMedCrossRef
36.
Eggener SE, Clark MA, Shikanov S, et al. Impact of warm versus cold ischemia on renal function following partial nephrectomy. World J Urol. 2015;33:351–7.PubMedCrossRef
37.
Ward JP. Determination of the optimum temperature for regional renal hypothermia during temporary renal ischaemia. Br J Urol. 1975;47:17–24.PubMedCrossRef
38.
Thompson RH, Leibovich BC, Lohse CM, Zincke H, Blute ML. Complications of contemporary open nephron sparing surgery: a single institution experience. J Urol. 2005;174:855–8.PubMedCrossRef
39.
Becker F, Van Poppel H, Hakenberg OW, et al. Assessing the impact of ischaemia time during partial nephrectomy. Eur Urol. 2009;56:625–34.PubMedCrossRef
40.
Thompson RH, Frank I, Lohse CM, et al. The impact of ischemia time during open nephron sparing surgery on solitary kidneys: a multi-institutional study. J Urol. 2007;177:471–6.PubMedCrossRef
41.
Godoy G, Ramanathan V, Kanofsky JA, et al. Effect of warm ischemia time during laparoscopic partial nephrectomy on early postoperative glomerular filtration rate. J Urol. 2009;181:2438–43. discussion 43-5.PubMedCrossRef
42.
Thompson RH, Lane BR, Lohse CM, et al. Every minute counts when the renal hilum is clamped during partial nephrectomy. Eur Urol. 2010;58:340–5.PubMedCrossRef
43.
Desai MM, de Castro Abreu AL, Leslie S, et al. Robotic partial nephrectomy with superselective versus main artery clamping: a retrospective comparison. Eur Urol. 2014;66:713–9.PubMedCrossRef
44.
Gill IS, Patil MB, Abreu AL, et al. Zero ischemia anatomical partial nephrectomy: a novel approach. J Urol. 2012;187:807–14.PubMedCrossRef
45.
Tomaszewski JJ, Smaldone MC, Mehrazin R, et al. Anatomic complexity quantitated by nephrometry score is associated with prolonged warm ischemia time during robotic partial nephrectomy. Urology. 2014;84:340–4.PubMedPubMedCentralCrossRef
46.
Altunrende F, Laydner H, Hernandez AV, et al. Correlation of the RENAL nephrometry score with warm ischemia time after robotic partial nephrectomy. World J Urol. 2013;31:1165–9.PubMedCrossRef
47.
Hayn MH, Schwaab T, Underwood W, Kim HL. RENAL nephrometry score predicts surgical outcomes of laparoscopic partial nephrectomy. BJU Int. 2011;108:876–81.PubMed
48.
Ginzburg S, Uzzo R, Walton J, et al. Residual parenchymal volume, not warm ischemia time, predicts ultimate renal functional outcomes in patients undergoing partial nephrectomy. Urology. 2015;86:300–6.PubMedCrossRef
49.
Lane BR, Russo P, Uzzo RG, et al. Comparison of cold and warm ischemia during partial nephrectomy in 660 solitary kidneys reveals predominant role of nonmodifiable factors in determining ultimate renal function. J Urol. 2011;185:421–7.PubMedCrossRef
50.
Thompson RH, Lane BR, Lohse CM, et al. Renal function after partial nephrectomy: effect of warm ischemia relative to quantity and quality of preserved kidney. Urology. 2012;79:356–60.PubMedCrossRef
51.
Gong IH, Hwang J, Choi DK, et al. Relationship among total kidney volume, renal function and age. J Urol. 2012;187:344–9.PubMedCrossRef
52.
Shin HS, Chung BH, Lee SE, Kim WJ, Ha HI, Yang CW. Measurement of kidney volume with multi-detector computed tomography scanning in young Korean. Yonsei Med J. 2009;50:262–5.PubMedPubMedCentralCrossRef
53.
Muto NS, Kamishima T, Harris AA, et al. Renal cortical volume measured using automatic contouring software for computed tomography and its relationship with BMI, age and renal function. Eur J Radiol. 2011;78:151–6.PubMedCrossRef
54.
Johnson S, Rishi R, Andone A, et al. Determinants and functional significance of renal parenchymal volume in adults. Clin J Am Soc Nephrol. 2011;6:70–6.PubMedPubMedCentralCrossRef
55.
Morrisroe SN, Su RR, Bae KT, et al. Differential renal function estimation using computerized tomography based renal parenchymal volume measurement. J Urol. 2010;183:2289–93.PubMedCrossRef
56.
Funahashi Y, Hattori R, Yamamoto T, Kamihira O, Sassa N, Gotoh M. Relationship between renal parenchymal volume and single kidney glomerular filtration rate before and after unilateral nephrectomy. Urology. 2011;77:1404–8.PubMedCrossRef
57.
Mir MC, Takagi T, Campbell RA, et al. Poorly functioning kidneys recover from ischemia after partial nephrectomy as well as strongly functioning kidneys. J Urol. 2014;192:665–70.PubMedCrossRef
58.
Hung AJ, Cai J, Simmons MN, Gill IS. “Trifecta” in partial nephrectomy. J Urol. 2013;189:36–42.PubMedCrossRef
59.
Simmons MN, Hillyer SP, Lee BH, Fergany AF, Kaouk J, Campbell SC. Nephrometry score is associated with volume loss and functional recovery after partial nephrectomy. J Urol. 2012;188:39–44.PubMedCrossRef
60.••
Meyer A, Woldu SL, Weinberg AC, et al. Predicting Renal Parenchymal Loss after Nephron Sparing Surgery. J Urol. 2015;194:658–63. Retrospective review of patients who underwent partial nephrectomy for a small renal mass to evaluate factors influencing renal parenchymal volume loss, as measure by 3-dimensional volumetric analysis. The study found that R.E.N.A.L. nephrometry score complexity and ischemia time were independently associated with an increased loss of renal parenchymal volume.PubMedCrossRef
61.
Ng CK, Gill IS, Patil MB, et al. Anatomic renal artery branch microdissection to facilitate zero-ischemia partial nephrectomy. Eur Urol. 2012;61:67–74.PubMedCrossRef
62.
Shao P, Qin C, Yin C, et al. Laparoscopic partial nephrectomy with segmental renal artery clamping: technique and clinical outcomes. Eur Urol. 2011;59:849–55.PubMedCrossRef
63.
Xu Y, Shao P, Zhu X, et al. Three-dimensional renal CT angiography for guiding segmental renal artery clamping during laparoscopic partial nephrectomy. Clin Radiol. 2013;68:e609–16.PubMedCrossRef
64.
Polascik TJ, Meng MV, Epstein JI, Marshall FF. Intraoperative sonography for the evaluation and management of renal tumors: experience with 100 patients. J Urol. 1995;154:1676–80.PubMedCrossRef
65.
Kaczmarek BF, Sukumar S, Kumar RK, et al. Comparison of robotic and laparoscopic ultrasound probes for robotic partial nephrectomy. J Endourol. 2013;27:1137–40.PubMedCrossRef
66.
Krane LS, Manny TB, Hemal AK. Is near infrared fluorescence imaging using indocyanine green dye useful in robotic partial nephrectomy: a prospective comparative study of 94 patients. Urology. 2012;80:110–6.PubMedCrossRef
67.
Tobis S, Knopf JK, Silvers CR, et al. Near infrared fluorescence imaging after intravenous indocyanine green: initial clinical experience with open partial nephrectomy for renal cortical tumors. Urology. 2012;79:958–64.PubMedCrossRef
68.
Tobis S, Knopf J, Silvers C, et al. Near infrared fluorescence imaging with robotic assisted laparoscopic partial nephrectomy: initial clinical experience for renal cortical tumors. J Urol. 2011;186:47–52.PubMedCrossRef
69.
McClintock TR, Bjurlin MA, Wysock JS, et al. Can selective arterial clamping with fluorescence imaging preserve kidney function during robotic partial nephrectomy? Urology. 2014;84:327–32.PubMedPubMedCentralCrossRef
70.
Bjurlin MA, Gan M, McClintock TR, et al. Near-infrared fluorescence imaging: emerging applications in robotic upper urinary tract surgery. Eur Urol. 2014;65:793–801.PubMedCrossRef
71.
Li QL, Guan HW, Zhang QP, Zhang LZ, Wang FP, Liu YJ. Optimal margin in nephron-sparing surgery for renal cell carcinoma 4 cm or less. Eur Urol. 2003;44:448–51.PubMedCrossRef
72.
Castilla EA, Liou LS, Abrahams NA, et al. Prognostic importance of resection margin width after nephron-sparing surgery for renal cell carcinoma. Urology. 2002;60:993–7.PubMedCrossRef
73.
Laryngakis NA, Van Arsdalen KN, Guzzo TJ, Malkowicz SB. Tumor enucleation: a safe treatment alternative for renal cell carcinoma. Expert Rev Anticancer Ther. 2011;11:893–9.PubMedCrossRef
74.
Longo N, Minervini A, Antonelli A, et al. Simple enucleation versus standard partial nephrectomy for clinical T1 renal masses: perioperative outcomes based on a matched-pair comparison of 396 patients (RECORd project). Eur J Surg Oncol. 2014;40:762–8.PubMedCrossRef
75.
Sciarra A, Von Heland M, Minisola F, Salciccia S, Cattarino S, Gentile V. Thulium laser supported nephron sparing surgery for renal cell carcinoma. J Urol. 2013;190:698–701.PubMedCrossRef
76.
Jackman SV, Cadeddu JA, Chen RN, et al. Utility of the harmonic scalpel for laparoscopic partial nephrectomy. J Endourol. 1998;12:441–4.PubMedCrossRef
77.
Lane BR, Derweesh IH, Kim HL, et al. Presurgical sunitinib reduces tumor size and may facilitate partial nephrectomy in patients with renal cell carcinoma. Urol Oncol. 2015;33:112 e15–21.PubMedCrossRef
78.
Johnson DB, Solomon SB, Su LM, et al. Defining the complications of cryoablation and radio frequency ablation of small renal tumors: a multi-institutional review. J Urol. 2004;172:874–7.PubMedCrossRef
79.
Thompson RH, Atwell T, Schmit G, et al. Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol. 2015;67:252–9.PubMedCrossRef
80.
Faddegon S, Ju T, Olweny EO, et al. A comparison of long term renal functional outcomes following partial nephrectomy and radiofrequency ablation. Can J Urol. 2013;20:6785–9.PubMed
81.
Mitchell CR, Atwell TD, Weisbrod AJ, et al. Renal function outcomes in patients treated with partial nephrectomy versus percutaneous ablation for renal tumors in a solitary kidney. J Urol. 2011;186:1786–90.PubMedCrossRef
Metadaten
Titel
Renal Function Following Nephron Sparing Procedures: Simply a Matter of Volume?
verfasst von
Michael J. Biles
G. Joel DeCastro
Solomon L. Woldu
Publikationsdatum
01.01.2016
Verlag
Springer US
Erschienen in
Current Urology Reports / Ausgabe 1/2016
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-015-0561-3

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