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Optimising assessment of kidney function when managing localised renal masses.

Abstract Increased early and incidental detection, improved surgical techniques and technological advancement mean that the management of renal mass lesions is constantly evolving. The treatment of choice for renal mass lesions has historically been radical nephrectomy. Partial nephrectomy is now recommended for localised renal masses, owing to favourable renal functional outcomes. Ablative renal surgery confers a significant risk of chronic kidney disease. There are few studies assessing long term outcomes of nephrectomy on renal outcomes, and virtually no studies assessing long term outcomes for less invasive therapies such as ablation. Unless a renal mass is clearly benign on imaging, management decisions will be made with an assumption of malignancy. The content of this review applies to both benign and malignant renal mass lesions. We advocate for improved strategies for kidney function assessment and risk stratification, early targeted referral, and regular screening for chronic kidney disease for all patients after surgery.
PMID
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Authors

Mayor MeshTerms

Nephrectomy

Keywords

Kidney diseases

Renal insufficiency

Urologic neoplasms

Journal Title the medical journal of australia
Publication Year Start




PMID- 28764630
OWN - NLM
STAT- MEDLINE
DA  - 20170802
DCOM- 20170807
LR  - 20170807
IS  - 1326-5377 (Electronic)
IS  - 0025-729X (Linking)
VI  - 207
IP  - 3
DP  - 2017 Aug 07
TI  - Optimising assessment of kidney function when managing localised renal masses.
PG  - 127-133
AB  - Increased early and incidental detection, improved surgical techniques and
      technological advancement mean that the management of renal mass lesions is
      constantly evolving. The treatment of choice for renal mass lesions has
      historically been radical nephrectomy. Partial nephrectomy is now recommended for
      localised renal masses, owing to favourable renal functional outcomes. Ablative
      renal surgery confers a significant risk of chronic kidney disease. There are few
      studies assessing long term outcomes of nephrectomy on renal outcomes, and
      virtually no studies assessing long term outcomes for less invasive therapies
      such as ablation. Unless a renal mass is clearly benign on imaging, management
      decisions will be made with an assumption of malignancy. The content of this
      review applies to both benign and malignant renal mass lesions. We advocate for
      improved strategies for kidney function assessment and risk stratification, early
      targeted referral, and regular screening for chronic kidney disease for all
      patients after surgery.
FAU - Ellis, Robert J
AU  - Ellis RJ
AD  - University of Queensland Diamantina Institute, Translational Research Institute, 
      Brisbane, QLD [email protected]
FAU - Joshi, Andre
AU  - Joshi A
AD  - Princess Alexandra Hospital, Brisbane, QLD.
FAU - Ng, Keng L
AU  - Ng KL
AD  - University of Queensland Diamantina Institute, Translational Research Institute, 
      Brisbane, QLD.
FAU - Francis, Ross S
AU  - Francis RS
AD  - University of Queensland Diamantina Institute, Translational Research Institute, 
      Brisbane, QLD.
FAU - Gobe, Glenda C
AU  - Gobe GC
AD  - University of Queensland Diamantina Institute, Translational Research Institute, 
      Brisbane, QLD.
FAU - Wood, Simon T
AU  - Wood ST
AD  - University of Queensland Diamantina Institute, Translational Research Institute, 
      Brisbane, QLD.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Australia
TA  - Med J Aust
JT  - The Medical journal of Australia
JID - 0400714
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Carcinoma, Renal Cell/pathology/*surgery
MH  - Catheter Ablation
MH  - Creatinine/blood
MH  - Disease Management
MH  - Glomerular Filtration Rate
MH  - Humans
MH  - Kidney/physiopathology
MH  - Kidney Neoplasms/pathology/*surgery
MH  - Magnetic Resonance Imaging
MH  - Mass Screening
MH  - *Nephrectomy
MH  - Referral and Consultation
MH  - Renal Insufficiency, Chronic/*epidemiology
MH  - Tomography, X-Ray Computed
OTO - NOTNLM
OT  - Kidney diseases
OT  - Renal insufficiency
OT  - Urologic neoplasms
EDAT- 2017/08/03 06:00
MHDA- 2017/08/08 06:00
CRDT- 2017/08/03 06:00
PHST- 2017/02/21 [received]
PHST- 2017/04/10 [accepted]
AID - 10.5694/mja17.00161 [pii]
PST - ppublish
SO  - Med J Aust. 2017 Aug 7;207(3):127-133.