Background: Percutaneous cryoablation (PCA) of renal tumors is a well-established alternative to partial nephrectomy, but the effects on renal function after the procedure are not well-documented. The purpose of this study was to evaluate renal function after computed tomography-guided PCA. Materials and Methods: A retrospective cohort study including 259 patients treated with PCA at Odense University Hospital, Denmark from January 1, 2015 to December 31, 2019. Both patients with malignant (96%) and benign tumors (4%) were included. Mean age of patients was 66.5 years (standard deviation [SD] = 10.9, range: 27-91) and 174 (67%) patients were men. Baseline estimated glomerular filtration rate (eGFR) was recorded at baseline and 12 months after cryoablation. Results: Mean tumor size was 27.5 mm (SD = 10.0) distributed in seven different histopathological types, mainly clear cell renal-cell carcinoma (RCC) (64%) and papillary RCC (22%). Mean eGFR at baseline was 73.7 mL/min/1.73 m2 (SD = 23.2) with a follow-up mean eGFR of 69.7 (SD = 23.7) (p < 0.0001). At baseline before intervention 190 patients (73%) had eGFR matching chronic kidney disease (CKD) groups 1 and 2 (normal to mild CKD), 64 patients (24%) matching CKD group 3 (average CKD), and 1% in groups 4 and 5. At 12-month follow-up, 171 patients (66%) had eGFR matching CKD groups 1 and 2, 77 patients (30%) matching CKD group 3 and 11 patients (4%) matching CKD groups 4 and 5. In patients with skewed renography who had PCA in the kidney with better excretion, eGFR at baseline was 64.7 and 61.2 at follow-up (p = 0.703). Conclusions: This study showed minimal decline in renal function 12 months after PCA, even for patients with reduced renal function. PCA is therefore considered a safe and relevant intervention.

中文翻译：

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经皮肾肿瘤冷冻消融对肾功能的影响。

背景：肾肿瘤的经皮冷冻消融术（PCA）是肾部分切除术的成熟替代方案，但手术后对肾功能的影响尚无充分记录。本研究的目的是评估计算机断层扫描引导 PCA 后的肾功能。材料和方法：一项回顾性队列研究，纳入 2015 年 1 月 1 日至 2019 年 12 月 31 日在丹麦欧登塞大学医院接受 PCA 治疗的 259 名患者。其中恶性肿瘤 (96%) 和良性肿瘤 (4%) 患者均纳入其中。患者的平均年龄为 66.5 岁（标准差 [SD] = 10.9，范围：27-91），其中 174 名 (67%) 患者为男性。在基线和冷冻消融后 12 个月记录基线估计肾小球滤过率 (eGFR)。结果：肿瘤平均大小为 27.5 mm (SD = 10.0)，分布在七种不同的组织病理学类型中，主要是透明细胞肾细胞癌 (RCC) (64%) 和乳头状肾细胞癌 (22%)。基线时的平均 eGFR 为 73.7 mL/min/1.73 m2 (SD = 23.2)，后续平均 eGFR 为 69.7 (SD = 23.7) (p < 0.0001)。在干预前的基线时，190 名患者 (73%) 的 eGFR 与慢性肾脏病 (CKD) 第 1 组和第 2 组（正常至轻度 CKD）相匹配，64 名患者 (24%) 与 CKD 第 3 组（平均 CKD）相匹配，1% 的组中4和5。在12个月的随访中，171名患者（66%）的eGFR与CKD组1和2相匹配，77名患者（30%）与CKD组3相匹配，11名患者（4%）与CKD组4和5相匹配. 肾造影不正常且肾脏有 PCA 且排泄更好的患者中，基线 eGFR 为 64.7，随访时为 61.2（p = 0.703）。结论：本研究显示 PCA 后 12 个月肾功能下降幅度很小，即使对于肾功能下降的患者也是如此。因此，PCA 被认为是一种安全且相关的干预措施。