We’ve all heard the slogans:
- Donate Your Spare
- You Only Need One
So on, so on, so on…
Yet these days, the standard treatment for small renal masses is what is known as kidney-sparing (or nephron-sparing) surgery. Surgeons used to remove the entire kidney, but they now only take as small a portion of the kidney as possible.
A newly published study spells out their reasoning:
“…partial nephrectomy provides equivalent oncological outcomes while also preserving renal function and preventing the adverse cardiovascular effects of chronic kidney disease.”
To be clear:
1. Chronic kidney disease is primarily determined by one’s renal function or GFR. Removing kidney mass (or an entire kidney) reduces nephron count and therefore, GFR.
2. Reduced kidney function, especially anything less than 60 GFR, is associated with a higher risk of cardiovascular disease and death.
Yet transplant centers are not required to inform prospective living kidney donors about the cardiovascular risks to relinquishing an entire kidney, and some surgeons have argued that the reduced GFR associated with the massive nephron loss resulting from living kidney donation isn’t inherently an indication of chronic kidney disease.
But according to contemporary medical literature, all of those things are a concern for otherwise healthy people who happen to have isolated kidney tumors.
Russo P (2013). Oncological and renal medical importance of kidney-sparing surgery. Nature reviews. Urology PMID: 23459033