What’s new in renal cancer research?

Patients with renal masses often undergo partial nephrectomy (PN) to preserve kidney function without compromising cancer-specific outcomes. Because hypertension and diabetes are leading causes of chronic kidney disease, the Icahn School of Medicine at Mount Sinai sought to determine the influence of diabetes and hypertension on renal function outcomes of patients undergoing robot-assisted PN (RPN).1 The analysis included patients who underwent RPN for a clinical stage less than T1b renal mass with normal baseline kidney function (estimated glomerular filtration rate [eGFR] higher than 60 mL/min/1.73 m2) and a followup of more than two weeks. Patients were categorized according to their eGFR (higher than 90 mL/min/1.73m2 vs. higher than 60 mL/min/1.73 m2) and the presence or absence of diabetes or hypertension; 57.86% of patients with a baseline eGFR of 90 or higher and 61.11% of patients with a baseline eGFR of 60 or higher had diabetes or hypertension. No differences in eGFR, renal function recovery profile over time, or chronic kidney disease (CKD) stage were observed in either group following RPN. The percentage of subjects upgraded to CKD stage 3 or higher did not differ between those with and without hypertension or diabetes, regardless of whether their baseline eGFR was higher than 90 mL/min/1.73 m2 or higher than 60 mL/min/1.73 m2. These data suggest that neither diabetes nor hypertension is an independent predictor of renal function outcomes in patients with normal renal function undergoing RPN. However, it was pointed out during the poster presentation that a potential bias was introduced by grouping together patients with uncontrolled hypertension and those with hypertension controlled by medication, which could potentially have a protective effect on renal function