Renal function outcomes following endoscopic management of upper tract urothelial carcinoma.
Publication Title
World journal of urology
Document Type
Article
Publication Date
5-22-2026
Keywords
Humans; Ureteral Neoplasms; Female; Kidney Neoplasms; Male; Carcinoma, Transitional Cell; Glomerular Filtration Rate; Aged; Retrospective Studies; Renal Insufficiency, Chronic; Treatment Outcome; Ureteroscopy; Middle Aged; Postoperative Complications; Chronic kidney disease; Endoscopic management; Renal failure; Renal function; Upper Tract Urothelial Carcinoma.; california; santa monica
Abstract
PURPOSE: Endoscopic management offers renal-sparing approaches for upper tract urothelial carcinoma (UTUC). We sought to characterize the impact of endoscopically managing UTUC on kidney function and identify predictors of renal function decline.
METHODS: We queried a multi-institutional cohort of endoscopically managed UTUC. Estimated glomerular filtration rate values 12 months after endoscopic treatment were assigned according to the National Kidney Function Kidney Disease Outcomes Quality Initiative (KDOQI) chronic kidney disease (CKD) stages. Loss of kidney function was defined as an increase by at least one CKD stage. Severe loss was defined as an increase by at least 2 CKD stages or development of CKD stage 3b-5.
RESULTS: A total of 339 patients (521 interventions) were included. 113 patients (33.3%) experienced loss of kidney function and 75 (22.1%) experienced severe loss of kidney function. In multivariable logistic regression, high grade tumor (OR 2.29, 95% CI 1.23-4.33) and renal pelvic location (OR: 2.64, 95% CI 1.32-5.54) were significantly associated with loss of kidney function on a per-patient level. We observed similar results on a per-intervention analysis, with higher odds for kidney function loss for high grade tumor (OR 2.03, 95% CI 1.23-3.35) and renal pelvic location (OR 1.76, 95% CI 1.01-3.08).
CONCLUSION: Despite preservation of the renal unit, one-third of patients undergoing endoscopic management of UTUC experience loss of kidney function. High-grade tumors and renal pelvic location were associated with adverse renal function outcomes.
Area of Special Interest
Cancer
Area of Special Interest
Kidney & Diabetes
Specialty/Research Institute
Oncology
Specialty/Research Institute
Nephrology
Specialty/Research Institute
Endocrinology
DOI
10.1007/s00345-026-06478-y
