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67th Annual Meeting Abstracts
Renal Functional Outcomes Following Percutaneous and Laparoscopic Cryoablation of Small Renal Masses
*Joshua E Logan, *John B. Malcolm, *Tristan Berry, *Michael B. Williams, *Harlan Vingan, Robert Given, *Raymond Lance, Michael D. Fabrizio
Eastern Virginia Medical School, Norfolk, VA
Introduction:
Renal functional outcomes after renal cryosurgery have not been widely scrutinized. We report two-year renal functional outcomes from a single-center cohort of patients treated with cryoablation of small renal masses.
Methods:
We performed a retrospective review of our laparoscopic and percutaneous renal cryoablation experience between 1/2003 and 4/2007. Global renal function was assessed using measured serum creatinine and estimated GFR (MDRD equation). Chronic kidney disease (CKD) was defined as serum creatinine > 2.0 mg/dL or eGFR < 60 ml/min/1.73m2.
Results:
62 patients were included in the analysis. Mean follow-up was 30 months (range: 13-63). Mean tumor size was 2.33 cm (range: 1-4.6cm). Comorbid conditions were prevalent: 77% HTN, 35% HLD, 31% DM, 39% tobacco use, and 32 % heart disease (CAD/CHF). Based on eGFR calculations, preoperative CKD was noted in 17 of 62 (27%) patients. De novo CKD developed in 5 of 45 patients (11%). Patients developing de novo CKD had lower pretreatment eGFR (71.0 vs. 98.4 60 ml/min/1.73m2, p = 0.03) and larger tumor size (2.94 vs. 2.19 cm, p = 0.04) compared to patients maintaining normal renal function. When CKD was defined as Cr > 2.0 mg/dL, only 1 and 6 patients were identified with preoperative and de novo CKD, respectively.
Conclusions:
In a cohort of renal cryosurgery patients characterized by highly prevalent medical comorbidities, renal function was generally well maintained, with a low rate of de novo CKD based on eGFR calculations. Serum creatinine > 2.0 mg/dL was a less sensitive measure of CKD.
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