Incidence of Proteinuria Post Radical Nephrectomy in Comparison to Partial Nephrectomy: A Comparative Study.

Abstract

Objectives The objective of this study is to enhance understanding of the incidence and impact of proteinuria following nephrectomy, to guide clinical decision-making, and to optimize post-operative monitoring strategies. Specifically, the study seeks to compare the incidence of proteinuria in patients undergoing radical nephrectomy and those receiving partial nephrectomy, thereby contributing valuable insights into post-surgical outcomes that could inform treatment approaches and improve patient care. Methods It is a retrospective cohort design, analyzing clinical data from patients who underwent radical or partial nephrectomy in King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, between 2014 and 2022. Data was entered in Excel (Microsoft Corporation, Redmond, Washington, United States) and analyzed in IBM SPSS Statistics for Windows, Version 29.0 (Released 2023; IBM Corp., Armonk, New York, United States). Results There was a total of 310 participants, predominantly male (n=167, 53.9%), with radical nephrectomy (n=188, 60.6%) being more common than partial (n=99, 31.9%). Post surgery, a significant decline in estimated glomerular filtration rate (eGFR) was noted in radical nephrectomy at one to three months (73.09 mL/minute) compared to partial nephrectomy (90.99 mL/minute) (p<0.001), with similar trends at 6-12 months. The mortality rate was low at 1.6% (n=5), with significant associations between preoperative eGFR and mortality (p=0.008). Proteinuria post operation was observed in 27.1% (n=84), with significant differences in proteinuria levels between radical (107.10 mg/dL) and partial nephrectomy (62.80 mg/dL) (p=0.031). Conclusion Our study found that radical nephrectomy was more common and associated with a greater decline in postoperative eGFR compared to partial nephrectomy. Proteinuria was significantly higher in radical nephrectomy patients, and preoperative eGFR was linked to mortality risk, highlighting the need for careful monitoring in high-risk individuals.