Impact on Renal Function of Percutaneous Thermal Ablation of Renal Masses in Patients with Preexisting Chronic Kidney Disease
Impact on Renal Function of Percutaneous Thermal Ablation of Renal Masses in Patients with Preexisting Chronic Kidney Disease
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DOI：
10.1016/j.jvir.2011.09.002
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发表时间：
2012-01-01
影响因子：
2.9
通讯作者：
Stavropoulos, S. William
中科院分区：
文献类型：
--
作者：
Wehrenberg-Klee, Eric;Clark, Timothy W. I.;Stavropoulos, S. William
目的：研究经皮肾肿瘤热消融术对基线慢性肾脏病（CKD）患者肾功能的影响。材料和方法：基线CKD患者（初始肾小球滤过率[GFR] < 60 mL/min/1.73 m（2））接受经皮冷冻消融或射频消融治疗肾肿块的患者。共有48名GRF为60 mL/min/1.73 m2或更低的患者接受了肾脏冷冻消融或RF消融治疗，并在1个月后进行了随访GFR测量。患者平均年龄为73岁（范围：47-89岁）。22例患者进行冷冻消融，26例患者进行射频消融。平均肿瘤直径为3.4 cm（范围：0.9-10.2 cm）。基线时平均总体GFR为39.8 mL/min/1.73 m2，消融术后1个月为39.7 mL/min/1.73 m2（P = 0.85）。共有38例患者进行了1年随访GFR测量（冷冻消融，n = 18;射频消融，n = 20），其平均GFR为40.9 mL/min/1.73 m（2）+/- 11.4（SD），而消融前GFR为41.2 mL/min/1.73 m（2）（P = 0.79）。在冷冻消融组中，1个月和1年时的平均GFR分别为41.4 mL/min/1.73 m（2）和44.4 mL/min/1.73 m（2），而基线GFR分别为41.1 mL/min/1.73 m（2）和42.1 mL/min/1.73 m（2）（分别为P = .75和P = .19）。在射频消融组中，1个月和1年时的平均GFRs分别为38.2 mL/min/1.73 m（2）和37.8 mL/min/1.73 m（2），而基线GFRs分别为38.7 mL/min/1.73 m（2）和40.4 mL/min/1.73 m（2）结论：与消融方式无关，经皮肾肿块消融似乎不会影响CKD患者的肾功能。
Purpose: To examine the effect of percutaneous thermal ablation of renal masses on renal function among patients with baseline chronic kidney disease (CKD).Materials And Methods: Patients with baseline CKD (initial glomerular filtration rate [GFR] < 60 mL/min/1.73 m(2)) who underwent percutaneous cryoablation or radiofrequency (RF) ablation of renal masses were reviewed.Results: A total of 48 patients with a GRF of 60 mL/min/1.73 m(2) or lower were treated with renal cryoablation or RF ablation and had follow-up GFR measurement 1 month afterward. Mean patient age was 73 years (range, 47-89 y). Cryoablation was performed in 22 patients and RF ablation was performed in 26. Mean tumor diameter was 3.4 cm (range, 0.9-10.2 cm). Mean overall GFRs were 39.8 mL/min/1.73 m(2) at baseline and 39.7 mL/min/1.73 m(2) at 1 month after ablation (P = .85). A total of 38 patients had 1-year follow-up GFR measurement (cryoablation, n = 18; RF ablation, n = 20), and their mean GFR was 40.9 mL/min/1.73 m(2) +/- 11.4 (SD), compared with a preablation GFR of 41.2 mL/min/1.73 m(2)(P = .79). In the cryoablation group, mean GFRs at 1 month and 1 year were 41.4 mL/min/1.73 m(2) and 44.4 mL/min/1.73 m(2), compared with respective baseline GFRs of 41.1 mL/min/1.73 m(2) and 42.1 mL/min/1.73 m(2) (P = .75 and P = .19, respectively). In the RF ablation group, mean GFRs at 1 month and 1 year were 38.2 mL/min/1.73 m(2) and 37.8 mL/min/1.73 m(2), compared with respective baseline GFRs of 38.7 mL/min/1.73 m(2) and 40.4 mL/min/1.73 m(2) (P = .58 and P = .09, respectively).Conclusions: Independent of ablation modality, percutaneous renal mass ablation does not appear to affect renal function among patients with CKD.