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Split renal function after treatment of small renal masses: comparison between radiofrequency ablation and laparoscopic partial nephrectomy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.ORCID iD: 0000-0003-0771-0032
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
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2021 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 62, no 9, p. 1248-1256, article id 284185120956281Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Radiofrequency ablation (RFA) and laparoscopic partial nephrectomy (LPN) are used to treat small renal masses (SRM; ≤4 cm), although there are conflicting results in the changes in creatinine and estimated glomerular filtration rate (eGFR) after treatment. On contrast-enhanced computed tomography (CE-CT) images, the quantity and quality of renal function can be evaluated by calculating the split renal function (SRF).

PURPOSE: To compare renal function after RFA or LPN treatment of SRMs through evaluation of the SRF in the affected kidney.

MATERIAL AND METHODS: Single T1a renal tumors successfully treated with RFA (n = 60) or LPN (n = 31) were retrospectively compared. The SRF was calculated on pre-treatment CE-CT images and the first follow-up exam after completed treatment. Serum creatinine and eGFR values were collected simultaneously. To compare renal function outcomes, Student's t-test and multivariable linear regression models (adjusted to RFA/LPN treatment, pre-treatment SRF/eGFR, BMI, age, tumor characteristics, and Charlson Comorbidity Index) were used.

RESULTS: SRF was reduced in both groups, although reduction was greater in the LPN group (LPN -5.7%) than in the RFA group (RFA -3.5%; P = 0.013). After adjusted analysis, the LPN group still had greater SRF reduction (difference 3.2%, 95% confidence interval 1.3-1.5; P = 0.001). There was no difference between groups in the change of creatinine/eGFR after treatment.

CONCLUSION: Both RFA and LPN are nephron-sparing when treating SRMs. However, in this series, reduction of SRF in the affected kidney was smaller after RFA, having a more favorable preservation of renal function than LPN.

Place, publisher, year, edition, pages
Sage Publications, 2021. Vol. 62, no 9, p. 1248-1256, article id 284185120956281
Keywords [en]
Kidney, ablation procedures, computed tomography, percutaneous
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-419713DOI: 10.1177/0284185120956281ISI: 000568579700001PubMedID: 32910686OAI: oai:DiVA.org:uu-419713DiVA, id: diva2:1467655
Available from: 2020-09-16 Created: 2020-09-16 Last updated: 2024-01-15Bibliographically approved

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Acosta Ruiz, VanessaWernroth, LisaLönnemark, MariaDahlman, PärMagnusson, Anders
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