Objective: To find out the pattern of change in post-operative renal function in patients who underwent radical nephrectomy for renal cell carcinoma.

Patients and Methods: A retrospective review of histological and biochemical findings in all patients who underwent RN for RCC over a period of 4 years was done. Study group comprised of 106 cases. Estimated glomerular filtration rate (eGFR) was calculated pre-operatively, 2 weeks and 3 months postoperatively and 6 monthly thereafter with a median follow up period of 24 months. Clinical variables that were evaluated included the age, sex, co-morbidities particularly diabetes mellitus (DM) and hypertension, tumor size, tumor stage, and preoperative estimated GFR(eGFR).

Results: The incidence of a moderate decrease in GFR after RN was 44 (48.88%).^.Patients with pT1a tumors had significantly higher mean baseline pre-operative eGFR compared to other T stages and the eGFR decline was also highest for T1a cases. There was significant negative correlation between tumor size and pre-operative eGFR. Age, DM, preop GFR, tumor size and tumor stage were found to be strong determinants of decline in GFR postoperatively.

Conclusions: eGFR decline seems to be more for those with small renal tumors and they might derive the most benefit from NSS.

Keywords: Renal function, Renal cell Carcinoma, Radical Nephrectomy, Glomerular filtration rate.

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Shanmugha Das K.V

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