Risk Factors For Renal Function Changes After Radical Resection In Patients With Kidney Cancer

Objective: As we all know,radical resection of the kidney plays an important role in the treatment of kidney tumors,and its treatment effect significantly improves the prognosis of patients with kidney tumors.Radical nephrectomy was once widely used as a standard treatment for renal malignant tumors,and with the passage of time,more and more clinicians realized the harm of chronic kidney disease caused by radical nephrectomy,and nephron-sparing surgery gradually emerged,but how to balance tumor efficacy and renal function has attracted much attention.This article collects the information of patients who have undergone radical nephrectomy in Yijishan Hospital of Wannan Medical College since 2003,aiming to quantitatively analyze the changes of unilateral renal function after radical nephrectomy and the related risk factors affecting renal function,so as to provide guidance for patients with some complicated renal tumors in clinical practice for optimal tumor control and better renal function selection.Methods: In order to screen out the trend of renal function in renal cancer patients after radical resection of kidney cancer and the clinical risk factors for chronic CKD after surgery,the basic clinical data of 212 kidney cancer patients and the creatinine value data of preoperative,intraoperative 1 week,1 month,6 months and 1 year after surgery were collected,and the glomerular filtration rate was estimated as an evaluation index of renal function.The results were mixed linear models to analyze the trend of postoperative e GFR in kidney cancer patients,and logistic binary and multiple regression analysis was used to find the risk factors affecting postoperative renal function changes.Results: In general,the renal function of patients with renal cancer showed a trend of gradual recovery during the 1-year period after radical nephrectomy.The slope of correlation between e GFR and time after RN was 0.378(95% confidence interval [CI] 0.007-0.749;P<=0.045),indicating that e GFR increased 0.378 m L/min/1.73m2 every month after RN.When we analyze renal function based on various factors,the recovery trend of e GFR in patients with hypertension,diabetes,and the elderly(>70 years old)after surgery is not significant,indicating that there is no improvement in their renal function.Preoperative predictors of increased e GFR after RN were youth,no hypertension,and no diabetes.Conclusion: Renal function decreased slightly in the first 3 months during the 1-year follow-up period after RN,but showed a continuous recovery from the overall trend of 1 year.However,the trend towards changes in renal function recovery varies according to various clinical factors,such as: hypertension,diabetes,and the risk of developing CKD after RN surgery in older patients,so this information should be discussed with the patient when consulting for the treatment of renal cell carcinoma(RCC).