Partial nephrectomy’s benefits unknown to some

June 3, 2013

Physicians and patients alike may not be aware of the benefits of nephron-sparing surgical methods, according to a recent study.

Physicians and patients alike may not be aware of the benefits of nephron-sparing surgical methods, according to a recent study.

Radical nephrectomy has been shown to increase the risk of developing chronic kidney disease and associated cardiovascular complications when used to treat small renal tumors. Despite the risks, researchers from Memorial Sloan-Kettering Cancer Center and Weill Medical College, New York, found that a majority of kidney cancer patients, even those already diagnosed with chronic kidney disease, still underwent radical surgery.

“It’s disheartening to know that radical nephrectomy is much more commonly performed even though a less aggressive surgery is as effective and prevents or delays the onset of chronic kidney disease,” said first author Paul Russo, MD.

Dr. Russo and his colleagues found that partial nephrectomy was utilized in less than 20% of kidney cancer patients surveyed. Even 80% of those with early-stage kidney cancer had their entire kidneys removed. The authors also found that most of those who underwent radical nephrectomy were unaware of the risk for developing or worsening chronic kidney disease.

“Overall, there seems to be a general lack of understanding of the complications to kidney function that can come along with radical nephrectomy,” Dr. Russo said. “Our study clearly indicates the need for enhanced education of medical and surgical professionals, and patients and their caregivers alike in the importance of kidney-sparing options for the management of small kidney tumors."

Of the 365 patients who participated in the study, over 75% had a radical nephrectomy. Of the patients who already were diagnosed with chronic kidney disease, 79% were also given radical nephrectomy despite the possibility of worsening their condition.

More than 25% of patients said they were not told about partial nephrectomy, its benefits, and whether they were a candidate for such an operation.

Results from the study were published in the American Journal of Kidney Diseases (2013; 61:939-46).

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