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The following is a summary of “Chronic renal impairment predicts oncological outcomes in UTUC patients undergoing RNU,” published in the November 2024 issue of Urology by Wong et al. 

Researchers conducted a retrospective study on the impact of renal impairment in patients with upper tract urothelial carcinoma (UTUC) undergoing RNU. They found it predicted worse disease-free survival (DFS). 

They collected data on patients with non-metastatic UTUC from the Clinical Research Office of the Endourology Society Urothelial Carcinomas of the Upper Tract (CROES-UTUC) Registry. They categorized patients into normal renal function and chronic renal impairment (CKD) groups, with CKD defined as an eGFR below 60 mL/kg/1.73 m². They used Kaplan–Meier survival analysis to assess DFS and overall survival (OS) and applied multivariable Cox regression to adjust for confounding variables. 

The results showed that of 1, the results showed that of 1,393 patients with UTUC, 875 (62.4%) had a normal renal function, and 528 (37.6%) had CKD. CKD was associated with worse DFS (HR=1.419, 95% CI=1.060–1.898, P=0.019). Higher T stage was associated with worse DFS (HR=4.613, 95% CI=1.829–4.712, P<0.001), as was adjuvant chemotherapy (HR=1.858, 95%CI=1.229–2.807, P=0.003). Cardiovascular disease and higher T stage were linked to worse OS, but baseline renal impairment did not affect OS. 

They concluded that preoperative CKD independently predicted poorer DFS in patients with non-metastatic UTUC undergoing RNU. Preoperative CKD was identified as a potential clinical predictor of worse oncological outcomes. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01627-0