Comparison of renal function following donor nephrectomy versus radical nephrectomy for renal tumor

In this study,we compared renal function in patients after donor nephrectomy (DN) and radical nephrectomy (RN). We retrospectively reviewed 68 patients (mean follow-up 15 months),including 30 patients who had undergone DN and 38 patients who had undergone RN. The study was performed between April 2006 and July 2010 at a single institute. Patients were matched for age and co-morbidities (hypertension and diabetes mellitus). We calculated the estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease study group equation. Parameters studied included GFR (≥60 to 60 mL/min/1.73 m 2 ),serum creatinine ( 2.0 mg/dL), metabolic acidosis (serum bicarbonate 22 mmol/L) and proteinuria ( 30 mg). There were no significant demographic differences between the two study groups. After a mean follow-up of 15 months,low eGFR ( 60 mL/min/1.73 m 2 ) was seen in 28% and 6.7% of patients in the RN and DN groups,respectively (P = 0.03). Similarly,proteinuria was seen in 21% vs 0%,P = 0.007,and de novo elevated creatinine was seen in 13% vs 0%,respectively P = 0.04; thus the changes were greater in the RN group. Our study shows that undergoing RN had a significantly greater risk of developing renal insufficiency and proteinuria compared with age-and co-morbidity-matched patients undergoing DN. We concluded that patients undergoing RN show a significantly greater risk of developing renal insufficiency and proteinuria compared with the patients undergoing DN.