Rapid Communication: Chronic Renal Insufficiency after Laparoscopic Partial Nephrectomy and Radical Nephrectomy for Pathologic T1a Lesions

Abstract

To report the prevalence of new-onset renal insufficiency in patients undergoing laparoscopic partial nephrectomy (LPN) as compared to laparoscopic radical nephrectomy (LRN) for pathologic T1a lesions. Forty-eight patients and 37 patients with a normal contralateral kidney, preoperative creatinine (Cr) concentration 2.0 mg/dL. Subclinical renal insufficiency (Cr < 2.0, but calculated GFR <60 mL/min per 1.73 m2) was present in 57% of the LRN patients v 15% of the LPN patients. LPN preserves renal function more effectively than LRN for pathologic T1a lesions. Subclinical renal insufficiency (GFR <60 mL/min per 1.73 m2) was present in the majority of patients undergoing radical nephrectomy in our series. Importantly, this series included the use of warm ischemia in all cases.