Clinical course and function of contralateral kidney following radical nephrectomy for renal cell carcinoma

Between 1975 and 1991, 118 patients with renal cell carcinoma were admitted to Okayama University Hospital to undergo radical nephrectomy. We herein review these cases retrospectively to evaluate the postoperative clinical course and renal function of the contralateral kidney. Five of the 118 patients needed hemodialysis throughout the follow-up period; 2 had metastasis to the contralateral kidney, 1 had a renal pelvic tumour and 2 had contralateral renal insufficiency with chronic renal disease. The renal function of those patients whose creatinine clearance level was preoperatively above 50 ml/min, was preserved. However 3 of 5 patients with a preoperative level below 50 ml/min, and proteinuria tended to have elevated plasma creatinine levels after surgery. Our study suggests that nephron- sparing surgery is needed for patients with limited renal function.