Madison Krischak, MD, on using nephrometry scores to target renal biopsy

In a recent interview with Urology Times®, Madison Krischak, MD, outlined key findings from a study looking at the use of nephrometry scores to guide routine renal mass biopsies. These results were presented at the 2025 Society of Urology Oncology Annual Meeting in Phoenix, Arizona.

“As we all know, current [American Urological Association] guidelines recommend renal mass biopsy whenever it will influence management. In the context of that recommendation, we felt that maybe renal mass biopsy is being underutilized,” she explained. Krischak is a PGY-4 resident at the University of Michigan in Ann Arbor.

The study included a total of 943 patients with an available RENAL nephrometry score. Among all patients, 19% had low RENAL scores, 57% had intermediate RENAL scores, and 24% had high RENAL scores.

Data showed that approximately 10% of patients in the overall cohort who underwent radical nephrectomy for intermediate to high complexity masses had benign final pathology. Further, routine renal mass biopsy for patients with intermediate and high RENAL scores was associated with a 10-fold reduction in the risk of benign radical nephrectomy relative to patients who received no biopsy (1% vs. 10%; P = .002; 95% CI, 1.4 to 72.0).

According to Krischak, these findings suggest that nephrometry scores could serve as an additional tool to help guide decision-making about renal masses. The authors did note, however, that prospective validation of the findings were warranted, ideally in a randomized controlled trial.

REFERENCE

1. Krischak M, Daignault-Newton S, Croll B, et al. Stratifying biopsy use by nephrometry score could reduce benign radical nephrectomy: an analysis of MUSIC Kidney. Presented at: Society of Urologic Oncology Annual Meeting; December 2-5, 2025; Phoenix, Arizona. Abstract 83. https://suo-abstracts.secure-platform.com/a/gallery/rounds/24/details/4789