The effect of nephroureterectomy on glomerular filtration rate

OBJECTIVE To determine the effect of nephroureterectomy (NU) on the glomerular filtration rate (GFR), and to determine whether the estimated GFR after NU is influenced by age and other factors associated with renal impairment. PATIENTS AND METHODS We retrospectively identified 131 patients who had had a NU at either of two UK institutions. Their serum creatinine levels were recorded before and after NU, along with comorbidity data, and from this their GFR before and after NU was estimated using the Modification of Diet in Renal Disease Study Group equation. RESULTS At a median follow-up of 5 years there was an 18% deterioration in estimated GFR in the 131 patients. The percentage deterioration in estimated GFR was greater in those aged >= 70 years than in those aged < 70 years (20% vs 15% deterioration). Those with more risk factors for renal impairment had a greater percentage deterioration in estimated GFR than those with no such risk factors. CONCLUSIONS This study shows that NU has a profound effect on future estimated GFR, an effect that is further compounded in those with risk factors for renal impairment. This study therefore provides both the patient and the urologist with an idea of potential future renal function after NU and contributes greatly to preoperative counselling.