Predictive Model Identifies Patients Most at Risk for Kidney Failure After Nephrectomy

By Emily Menendez - Last Updated: August 29, 2023

While nephrectomy is commonly used to treat kidney cancer, it can result in loss of kidney function or kidney failure in some patients. No tools to determine which patients may be at risk for kidney failure are currently available, and so researchers developed a kidney cancer risk equation (KCRE) to predict the likelihood of kidney failure after nephrectomy in patients with localized kidney cancer.

Their study included a development cohort of 1026 patients with nonmetastatic kidney cancer who were treated with a partial or radical nephrectomy and had at least 1 estimated glomerular filtration rate (eGFR) measurement before and after nephrectomy. A separate validation cohort of 12,043 patients with localized kidney cancer who received a partial or radical nephrectomy and had at least 1 eGFR measurement before and after surgery was also included.

The study’s primary outcome was a composite of dialysis, transplantation, or an eGFR under 15 mL/min/1.73 m2 during the follow-up period.

An eGFR decline to less than 15 mL/min/1.73m2 occurred in 10.3% of patients in the development cohort, while 6.3% of patients in the validation cohort progressed to kidney failure. The KCRE model had a 5-year area under the curve of 0.85 in the development cohort and 0.86 in the validation cohort for predicting end-stage kidney disease.

The KCRE model can be accurately applied in clinical practice to inform discussions about kidney failure risk in patients with localized kidney cancer, researchers concluded.