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Nephron-Sparing Surgery Best Option For Patients With Common Risk Factors For Chronic Kidney Disease

September 24, 2017

Nephron-sparing surgery is the preferred treatment for patients with stage 1 kidney cancer, but this technique is not being used as frequently as it should be, particularly in patients with diabetes and high blood pressure, according to new data being presented at the 105th Annual Scientific Meeting of the American Urological Association (AUA). These data was presented to the media during a special press conference on Monday, May 31, 2010 at 2 p.m. PDT at the Moscone Center.

Kidney cancer is the most lethal urologic malignancy but, according to the "AUA Clinical Guideline for Management of the Clinical Stage 1 Renal Mass," released in 2009, nephron-sparing treatments are viable options that can remove the tumor while at the same time minimizing the patient's risk of future kidney dysfunction and cardiovascular disease. The use of nephron-sparing surgery may, therefore, be even more important among patients with existing risk factors for these conditions, such as diabetes or hypertension.

Using population-based data from the National Cancer Institute's U.S. Kidney Cancer Study, a multi-center team of researchers evaluated whether nephron-sparing surgery was more commonly used in patients with diabetes and/or hypertension than in those without these risk factors. Of the 894 patients who were treated surgically for renal cell carcinoma, only 20 percent underwent nephron-sparing treatment. Even among those with tumors less than 4 cm, a nephron-sparing approach was still used in only 34 percent of cases. While patients with both hypertension and diabetes were more likely to have received nephron-sparing treatment (28 percent overall) than those with neither risk factor (19 percent), usage rates were similar for patients who had only one compared with those having no risk factors.

"This study suggests that there is an opportunity to improve patient care by increasing use of this treatment for patients who may only have a single risk factor which might put the remaining kidney at risk" said Anthony Y. Smith, MD, a spokesman for the AUA. "Nephron-sparing surgery should really be considered for any patient with either diabetes mellitus or hypertension and not just for those patients who have both conditions."

American Urological Association