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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2013, Número 1

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Rev Invest Clin 2013; 65 (1)


Función renal a largo plazo en pacientes con cáncer de células renales tratados quirúrgicamente: comparación entre nefrectomía radical y parcial

López-Garibay LA, Cendejas-Gómez JJ, Rodríguez-Covarrubias F, Gómez-Conzatti A, Gabilondo-Navarro F, Sotomayor-de-Zavaleta M

Idioma: Español
Referencias bibliográficas: 30
Paginas: 7-11
Archivo PDF: 143.72 Kb.


RESUMEN

Objetivo. Comparar la función renal (FR) en pacientes con cáncer de células renales (CCR) tratados quirúrgicamente y evaluar el impacto de las dos técnicas quirúrgicas en la filtración glomerular (TFG). Material y métodos.Se analizó la base de datos de pacientes con tumores renales tratados con nefrectomía radical (NR) o parcial (NP). La FR se evaluó de manera preoperatoria y postoperatoria, y se comparó entre ambos grupos. La TFG se estimó mediante la fórmula CKDEPI. El análisis estadístico incluyó las pruebas de χ2, T de Student, Friedman y método de regresión logística (análisis multivariado).Resultados. 223 pacientes con CCR operados entre 1981 y 2010 tuvieron información completa. El tiempo de seguimiento fue de 67.6 ± 49.6 meses. No hubo diferencias significativas en las características basales entre el grupo de NR (n = 196) y NP (n = 27). A los seis meses se detectó una TFG ‹ 60 mL/min/1.73m2 en 63% vs. 29% (p = 0.0007), a los 12 meses en 64% vs. 33% (p = 0.002) y a los 60 meses en 53% vs. 40% (p = 0.2) de los pacientes de NR y NP, respectivamente. El descenso absoluto en la TFG fue de 22% y 17%, respectivamente. En el análisis multivariado la TFG preoperatoria y tipo de cirugía se asociaron con deterioro en la FR a seis y 12 meses. Conclusiones. La NR provoca mayor deterioro que la NP en la TFG a seis y 12 meses. A 60 meses, los pacientes tratados mediante NP mantienen una FR promedio › 60 mL/ min/1.73 m2.


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