Effects of percutaneous cryoablation for renal tumor on overall and split renal function

Takuji Yamagami; Rika Yoshimatsu; Noriko Nitta; Kana Miyatake; Hitomi Iwasa; Junki Shibata; Marina Osaki; Hitomi Maeda; Yoshihiro Noda; Tomoaki Yamanishi; Tomohiro Matsumoto; Shinkuro Yamamoto; Takashi Karashima; Keiji Inoue

doi:10.1007/s11604-024-01589-1

Effects of percutaneous cryoablation for renal tumor on overall and split renal function

Jpn J Radiol. 2024 May 15. doi: 10.1007/s11604-024-01589-1. Online ahead of print.

Authors

Takuji Yamagami¹, Rika Yoshimatsu^{2

3}, Noriko Nitta², Kana Miyatake², Hitomi Iwasa^{2

3}, Junki Shibata², Marina Osaki^{2

3}, Hitomi Maeda², Yoshihiro Noda², Tomoaki Yamanishi², Tomohiro Matsumoto², Shinkuro Yamamoto⁴, Takashi Karashima⁴, Keiji Inoue⁴

Affiliations

¹ Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, 783-8505, Japan. yamagami@kochi-u.ac.jp.
² Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, 783-8505, Japan.
³ Department of Radiology, Kochi Health Sciences Center, 2125-1 Ike, Kochi, Japan.
⁴ Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, 783-8505, Japan.

PMID: 38744807
DOI: 10.1007/s11604-024-01589-1

Abstract

Purpose: To evaluate retrospectively the influence of percutaneous cryoablation for small renal tumors on total and affected kidney function and risk factors associated with worsening function of the affected kidney.

Materials and methods: Between April 2016 and March 2022, 27 patients who underwent cryoablation for small renal tumors at our institution participated in this study, which investigated time-dependent changes in postoperative renal function. We evaluated estimated glomerular filtration rates (eGFRs) and split renal function revealed by scintigraphy using 99 m technetium-mercaptoacetyltriglycine (99mTc-MAG3) before cryoablation and at 1 week, 1 month, and 6 months after cryoablation. Numerous variables were analyzed to assess risk factors for worsening renal function.

Results: Baseline eGFR (mean ± standard deviation) was 56.5 ± 23.7 mL/min/1.73 m² (mean ± SD; range, 20.5-112.5). Mean eGFRs at 1 week, 1 month, and 6 months after cryoablation were 57.4 ± 24.5 (19.1-114.9), 57.1 ± 25.1 (21.5-114.9), and 53.8 ± 23.9 mL/min/1.73 m² (20.0-107.5), respectively. Changes were statistically insignificant (p = 1.0000, = 0.6749, and = 0.0761, respectively). Regarding split renal function, mean baseline contribution of the affected kidney determined by 99mTc-MAG3 was 49.7% ± 6.0% (38.8-63.3%); these rates at 1 week, 1 month, and 6 months after cryoablation were 43.7% ± 8.8 (29.1-70.6%), 46.2% ± 7.7% (32.6-70.3%), and 46.0% ± 8.5% (32.5-67.6%), respectively. Differences from baseline were significant for all periods (p < 0001, < 0001, = 0.0001, respectively). Serum C reactive protein and lactate dehydrogenase at 1 day following cryoablation, tumor's nearness to the collecting system or sinus, and volume of ablated normal renal parenchyma were significantly correlated with decreased contributions of the affected kidney by > 10% after cryoablation.

Conclusion: Unlike total renal function, affected kidney function could worsen after cryoablation.

Keywords: Cryoablation; Mercaptoacetyltriglycine; Renal functions; Renal tumor.