Partial nephrectomy helps preserve bone health

Patients who undergo radical nephrectomy experience a significantly higher incidence of osteoporosis and fractures when compared with those who undergo partial nephrectomy, according to a recent study.

"When weighing the risks and benefits of partial versus radical nephrectomy, doctors and patients should take into account the impact on a patient’s bone health," said senior author Ithaar Derweesh, MD, of the University of California, San Diego School of Medicine.

"This study illuminates the fact that preserving the kidney helps to prevent chronic kidney disease and significantly reduces bone fractures and risk of developing osteoporosis."

In their retrospective review of 905 patients, Dr. Derweesh and colleagues found significantly less postoperative osteoporosis in the partial nephrectomy cohort (12.5% vs. 22.6%, pp=.007). Female gender, Caucasian race, preoperative glomerular filtration rate

Radical nephrectomy is a significant risk factor for chronic kidney disease, which itself carries increased risk for metabolic complications, cardiovascular disease, and death. Partial nephrectomy leaves behind functional tissue and healthy cells that can help prevent or reduce the risk of metabolic disease leading to kidney dysfunction, muscle atrophy, and osteoporosis.

"Women facing kidney surgery should investigate whether partial kidney removal is an option to treat their disease, as it may help prevent bone brittleness," said co-author Christopher Kane, MD, of UCSD.

Results of the study were published online in Urology (July 19, 2011).